James Marusek

@@CassieThreatt I am sorry that you are experiencing many problems. I wish there was some advise I could give that would help. I did some internet searches. In the first http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334389/ it said: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women. To meet PCOS criteria, women must have a combination of hyperandrogenism, anovulation and ultrasound findings. Almost 10% of all reproductive age women worldwide show signs of PCOS. Although women often seek care for gynecological or body image concerns, many PCOS women are at risk for metabolic syndrome (MS). Many of the metabolic consequences are overlooked and undertreated by physicians because these patients tend to be young, reproductive age women. MS and obesity coexist commonly with PCOS. These young women are predisposed to glucose abnormalities and ultimately diabetes mellitus, dyslipidemia and eventually cardiovascular disease. Bariatric surgery can be an effective means of weight loss in PCOS women. Surgical techniques have become safer and less invasive over time and have been found to be effective in achieving significant weight loss. Surgical options have also increased, giving patients more choices. Bariatric surgery may prevent or reverse metabolic syndrome. Bariatric surgery may also have reproductive benefits in PCOS patients. Although bariatric surgery has historically been performed in older, reproductive aged women, it has recently gained favor in adolescents as well. This is of particular importance due to the prevalence of both PCOS and MS in adolescents. Treatment of PCOS and MS certainly requires a combination of medical therapy, psychological support and lifestyle modifications. These treatments are difficult and often frustrating for patients and physicians. Bariatric surgery can be effective in achieving significant weight loss, restoration of the hypothalamic pituitary axis, reduction of cardiovascular risk and even in improving pregnancy outcomes. Ultimately, bariatric surgery should be considered part of the treatment in PCOS women, especially in those with MS. This lead me to searches on metabolic syndrome (MS) and bariatric surgery. Those searches seemed to go nowhere. But then I remember reading some interesting research related to "The Biggest Loser" television show. http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html?_r=0 Many people who subjected themselves to very very intense exercise and diet regimes put their bodies in a long protracted starvation mode which slowed their metabolisms so that when they exited the intense regime, caused them to gain significant amounts of weight back. Some were even heavier than before they started. @@CassieThreatt, I suspect that since you "spent 15 years starving myself and running/working out to stay below 300 pounds . . . exercising twice daily at the gym and 600 calorie diet", you may have replicated their "The Biggest Loser" condition. The gastric bypass did not correct this condition. Before I had RNY gastric bypass surgery, I had diabetes. It crept up on me over the years. I was on 2 types of diabetes medicine and even at that my blood sugar levels were not under control. I went back to exercising and diet to try and lose weight, but my body was to the point that instead of losing weight I was still gaining weight. At that point and as my body was continuing to degrade, I decided to have RNY gastric bypass surgery. When I left the hospital 2 days after surgery, I was off my diabetes meds and haven't taken any since. I am over 3 years post-op. Anyways I think that a reversal of the gastric bypass surgery, will not correct the problems you are experiencing. If they ever come up with a solution for "The Biggest Loser" syndrome, I believe it will correct your problem also. The three most important elements after gastric bypass is to meet your daily Protein, Fluid and Vitamin requirements. It looks like you are tracking protein. I suspect you need to add addition Iron supplements to make sure your iron levels don't fall too low due to bleeding. But you probably are doing this already. It looks like you are avoiding processed sugar in all its forms. Some fruits have high levels of natural sugar which might be contributing to your diabetes. I guess I am out of advice. This is the approach I used in the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf I wish that I could offer you a bit more but I seem to be all tapped out today.

Boy, you sure had your share of complications. I am sorry you went through this and hope all goes well in the future. You indicated that the Vitamin Patches didn't work. I never used them myself but I think several individuals on this website have. I did a search on the internet and found that Bariatric Pal seems to endorse them. They had 214 reviews and all were 5 stars rated. [This causes me to wonder if these were honest reviews. There should at least be a 4 star or 3 star in the mix. But nada!] Now on the other hand when your doctor indicated "He says that there is no way that Vitamins absorb through the skin!" [i tend not to believe that either because I have been experimenting with essential oils and they absorb very quickly through the skin. I can detect absorption in about 7 minutes by experimentation. So if essential oils can be absorbed, it seems theoretically that vitamins could too. Also I suspect that quite a bit of research and testing went into patches before they were marketed.] So therefore a dilemma. Perhaps some of those on this website could chime in and discuss their use and satisfaction with the vitamin patches. Also if you had blood work done after using the patches and did they show deficiencies. @@HappilyEverAfter44 results showed major deficiencies. Is this common?

chicken can be hard to eat. But some of this can be overcome by food preparation. For example if you take a chicken breast and put it in a covered pot with Water and add a chicken bouillon cube and slow cook it until the chicken is so tender that it falls apart with a fork, it will go down much easier. Also chicken in soups will go down easier.

Oops another problem surfaced for Pokemon Go players. It is a security nightmare because of the threat of Android malware attached to mirror apps that open a backdoor into smartphones and secondarily because there is a known flaw which means, when users sign in through their Google account, the app has access to everything in those Google accounts Opens a New Window. – email, documents, pictures, etc. – without permission. http://www.foxbusiness.com/features/2016/07/21/pokemon-go-security-nightmare-for-byod.html

There are two phases to weight loss surgery. These are the Weight Loss phase and the Maintenance phase. I am 3 years post-op RNY gastric bypass surgery. This is the approach that I use in the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

I generally don't take my Vitamins with my meals. I deal with them separately and drink Water when I take them.

If you have severe acid reflux (GERD), RNY gastric bypass is recommended over sleeve because the sleeve will only make that condition worse.

There are two phases to weight loss surgery - the Weight Loss phase and the Maintenance phase. I am 3 years post-op RNY gastric bypass. This is the approach I used in the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

Good luck on your surgery.

Congratulations and let us know if we can be of any help.

Congratulations.

Congratulations.

Congratulations and let us know if we can be of any help.

When I transitioned to harder foods such as steak, it was a difficult transition. I found that softer foods such as chili and Soups went down easier, so that is what I primarily stayed with. But if you are finding that a half an antibiotic pill is going down hard, then perhaps you have a stricture. I don't know how far along you are. If you are within the first couple months and trying to transition to hard foods, there is nothing that prevents you from going slower with your transition to solids.

Some people find that hot fluids go down easier, some people find cold helps. So experiment. I found that drinking hot during the winter (tea, hot cocoa [no sugar added variety]) worked well in the cold winter and cold fluids such as flavored Water (crystal light) worked good in the hot summer. I have recently started to drink Bai which I buy by the case at Sam's club.

If you are lactose intolerant and drink milk or a product containing lactose, within a few minutes you will get an upset stomach and then a quick trip to the bathroom with diarrhea. In my case, lactose intolerance disappeared after about 2 months post-op. If you are lactose intolerant avoid products with milk or lactose. Some Protein drinks contain lactose, others don't. I used Muscle Milk Light powder and mixed it with Water for my Protein shakes.

As I said earlier I have no experience with brachioplasty and tummy tuck.

Might try an internet search. Here is one that is held monthly but there is probably more. http://montana.providence.org/hospitals/st-patrick/for-patients-and-visitors/support-group/ It describes a Weight Loss Surgery Support Group at the end.

I am buying Multivitamins from GNC but I buy them on-line and I wait until they have a "Buy one, get one free" sale. I no longer use Protein shakes because I am able to meet my protein goals from my meals - I am 3 years post-op RNY. But I sometimes use Quest Protein Bars that I buy bulk over Amazon.

Goal is somewhat an artificial number. I think when I went in and met the surgeon, he initially set my goal at 190 pounds. It was a number I could be satisfied with. In the end I dropped nearly 50 pounds lower than that initial artificial goal. So eventually after reviewing the mortality data, I decided the ideal goal weight would be on the high side of normal weight. Normal (or ideal) BMI is defined as 18.5-24.9. So my final goal and the weight level I am maintaining is 150 pounds. This translates to a Body Mass Index (BMI) of 24.2 Research studies show that mortality rates are significantly higher for those that are obese along with those that are underweight. It is important to have a little fat on the body because when major injury or illness strikes, this fat is the reservoir of energy that the body draws on until recovery. So my end goal is to maintain a normal healthy body weight. Some of the latest research that I have seen even shows that within the normal BMI range, those on the low side of normal suffer with a little higher mortality rate. @@Indieflickers If I interpret your question correctly you are asking if you can enter maintenance phase without reaching your goal. I think the answer is yes, your weight loss slows down the further out from surgery and then weight loss comes to a stop, not a stall, but a stop. That doesn't mean you could not drop some more weight in the Maintenance phase. It just happens in other ways. When you said "I'm ridiculously hungry all the time", it causes me to believe you are in the Maintenance phase. The goal of the Maintenance phase is Hunger Control.

I am 3 years post-op RNY gastric bypass surgery. After around 7 months, I slid from the Weight Loss phase into the Maintenance phase. The strategy for the Maintenance phase is different than the Weight Loss phase. This is my experience with the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

Congratulations on your weight loss of 212 pounds. I cannot speak about the swelling in your stomach after brachioplasty and tummy tuck. But I might be able to help with the hunger. I am over 3 years post-op RNY gastric bypass surgery. You are over a year post-op Gastric Bypass and most likely you are in the Maintenance phase. The Maintenance phase requires a different strategy than during the Weight Loss phase. This article describes my experience with the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf When I was young, I began to walk after work. I did this because I was becoming a little flabby and I thought walking would bring my weight down a little. Over a few weeks I built myself up to 10 miles per day. When I stepped on the scale, I found that to my surprise, I was gaining weight. [This is because I was replacing my fat with muscle and muscle weights more.] The amount of daily exercise you are getting is at a high level and you will need to consume more Protein to compensate. Otherwise your body will steal protein and this can cause you health problems. So I would recommend that you review you minimum daily protein requirements and make sure that requirement compensate for the high level of exercise you are getting.

Congratulations on your weight loss thus far.

It might be an ulcer. https://www.slhn.org/docs/newsletter/bariatrics%20-%20ulcers.pdf

Generally after surgery your meal volume will be very small. Therefore you will need to use a Protein supplement such as a protein shake in order to get in your daily protein requirements. These can come in powder form where you mix it with either Water or milk or as a premix. I never took my blender with me when I travel. It would be just too much hassle. I used premixed Protein shakes. Later after several months, I was able to transition to Protein Bars when I was up and about. Generally I found Soups and chili to go down easy.