James Marusek

I had to go through a 6 month medically supervised weight loss and exercise program in order to qualify for my insurance. During this time I attended Bariatric Surgery Support Group Meetings once per month. They are free and there are several located across the state. I went through a meeting with a psychologist which is a requirement for the surgery. I went through almost a day of classes that provided me with a very detailed list of requirements for post surgery and an overview of what to do for surgery. I went through almost a day of pre-op testing at the hospital. Because this testing raised some concerns, I went through a second round of pre-op testing performed by specialist in their respective fields. Then I had the surgery. This article describes my experience after surgery. http://www.breadandbutterscience.com/Surgery.pdf

The three most important daily requirements after RNY gastric bypass surgery is to meet your Protein, Fluid and Vitamin requirements. food is secondary because your body is converting stored fat into the energy that drives your body. Generally when patients are in the hospital for surgery, they gain weight because they fill your body with fluids. So you must first lose that weight before you see any major loss. Also during the first few weeks after surgery, your body is in a major heal mode. Weight loss after surgery is achieved through meal volume control, not necessarily through limiting your calories. So follow the requirements of the program for the meal volume. It should be about 2 ounces per meal in the beginning, which is incredibly small. Therefore you will need to supplement this with a protein supplement such as several Protein shakes per day. So meet your daily requirements for protein, fluids and Vitamins, walk 30 minutes per day (or equivalent exercise) and stick to the program requirements for meal volume and then let the magic happen.

Congratulations.

Congratulations on your weight loss thus far. After you come off the antibiotics remember to take some Probiotics to reestablish the colony of good bacteria in your gut. Here is my experience with RNY surgery. http://www.breadandbutterscience.com/Surgery.pdf I have included some recipes in the back once you get a little further along.

Good luck on your surgery and check back with us when you are on the other side.

I am 3 years post-op RNY gastric bypass surgery at St. Vincent Bariatric Center. It is a center of excellence in bariatric surgery and I highly recommend it. Especially since they are finally finished with road construction leading to the facility.

Welcome. I had RNY gastric bypass over 3 years ago. The following article describes my experience. http://www.breadandbutterscience.com/Surgery.pdf Walking is the best way to deal with gas.

It is common for patients to be unable to meet their Protein and Fluid requirements during the first few weeks after surgery. Their bodies are in a major heal mode. Keep trying each day and you should be able to get there. My taste buds changed after surgery and many things tasted terrible. You may need to experiment with various types of Protein shakes in order to find one that you can tolerate. There are a wide variety out there. You don't have to like it, just tolerate it. Can you drink milk. Eight ounces of 1% milk has 8 grams. If you fortify the milk by adding in a quarter cup of dry powdered milk, it bring it up to 14 grams. Yogurt (light smooth variety) was on my approved lists of foods from the beginning. But it cannot be the yogurt with the fruit on the bottom. Greek yogurt has substantially more protein than normal yogurt.

It is common for patients to be unable to meet their Protein and Fluid requirements during the first few weeks after surgery. Their bodies are in a major heal mode. Keep trying each day and you should be able to get there. You may need to experiment with various Protein shakes in order to find one that you can tolerate. There are a wide variety out there. You don't have to like it, just tolerate it. Can you drink milk. Eight ounces of 1% milk has 8 grams. If you fortify the milk by adding in a quarter cup of dry powdered milk, it bring it up to 14 grams.

I tend to agree with the others and doubt this was caused by dumping syndrome. I suspect some time of flu bug or food poisoning. Since eating seems to trigger this, you might have a problem going out to dinner tonight.

Sorry to hear of your loss.

Never heard of it. Stalls are common in gastric sleeve surgery. Some on this site have coined the phrase "Embrace the Stall". I had RNY gastric bypass and the stalls are less common. But I did encounter a couple. After RNY gastric bypass, I was restricted to 2 ounces per meal. Over the next year and a half that was increased slowly to 1 cup. Because of the low volume of meal size initially, there was no way I could get in the required amount of Protein my body needed from meals alone and therefore I had to resort to using a protein supplement (protein shakes). But as my meal volume increased and because I concentrated on consuming high protein meals, I was able to begin to drop of the Protein shakes. So I went from 3 a day, down to 2, down to 1 and finally eliminated them all together at a year and a half. This was important because the protein shakes do contain calories. Anyways this was the approach that I used to break my stalls.

I guess I am missing something. What is causing your low hemoglobin numbers (or blood loss)? Can this condition be corrected by medication/surgery? Many times through the pre-op diagnosis process, problems are identified, then corrected, then the weight loss surgery occurs. So I think you are at a stage where the underlying issue needs to be corrected. There was a man in our Bariatric Surgery Support Group who was scheduled for surgery the following week. He was called in by the surgeon because his pre-op results showed he was about to have a heart attack. He went into the hospital and had open heart surgery. When I saw him the next time at the meeting, he had lost a little weight due to the bypass operations and once he recovered was schedule again for his weight loss surgery. My mother suffered from low hemoglobin numbers. She go so weak that we had to take her into the emergency room and she received a blood transfusion. After testing it was determined she was bleeding internally. My mom suffered from constant pain and as a result she used excedrin for it. But excedrin uses a high amount of aspirin (a blood thinner). And she had been popping these like candy for several years, and this finally caused her internal bleeding. We took her off the excedrin and her blood loss stopped and her hemoglobin numbers came back. This has been several years now and this problem has not reoccurred.

Congratulations on your outstanding weight loss both pre-op and post-op. It seems like you have a slew of questions, so let me talk about them one at a time. The three most important daily requirements after RNY gastric bypass surgery are meeting your daily Protein, Fluid and Vitamin requirements. food is secondary because your body is converting stored fat into the energy that drives your body. Thus you lose weight. So generally your surgical team have given you minimum requirements for protein and fluids. Fluids - Your fluid requirement is met by a combination. It includes the Water you drink to swallow your Vitamins in the morning. It includes water and milk. It includes the liquid in your Soup. It includes tea and decaf coffee or crystal light. It includes the water in your Protein shakes. Some people found hot liquids go down easier, while others find cold liquids help. For me, my desires are somewhat seasonal. In the hot summer I drink a lot of crystal light lemonade. In the cold winter, I drink hot cocoa (no sugar added variety). So your requirement is fluids, not just water. Once I understood the fluid requirement and started adding up all the fluid that I drink each day, I found it wasn't hard to meed this requirement. [One of the reasons why you have a fluid requirement is that as your fat cells dissolve, they release chemicals and hormones that were stored in your fat cells into your system. These need to be flushed through your system, then your kidneys and finally expelled in your urine. So you require fluids to make this process work properly.] Protein - Your protein requirement is met by a combination of the protein from supplements (protein shakes, protein bars) combined with the protein you obtain from meals. Right after RNY gastric bypass surgery, your meal volume is limited to 2 ounces per meal and it is almost impossible to obtain this protein from meals alone. Therefore one relies on supplements, such as protein shakes. But as your meal volume increases over time, you will have the option if you concentrate on consuming high protein meals of reducing your reliance on protein shakes. I went from 3 protein shakes a day, down to 2, then down to 1 and finally when my meal volume increased to 1 cup per meal, I took myself completely off protein shakes. This is important because your protein shakes do include calories. As I hit stalls after surgery, this reduction in protein shakes played a major component of breaking these stalls. Calories - Weight loss is achieved after RNY surgery by meal volume control, not controlling the number of calories you consume. The one exception is given above. At the end of the following article, I have included some recipes for high protein meals. http://www.breadandbutterscience.com/Surgery.pdf

Congratulations on your weight loss. Some of the excess skin will contract over the next year. Also some forms of exercise can help tighten the skin. In general I did not find the loose skin/stretch marks to be a problem. I am 3 years post-op RNY. The only area that I am dissatisfied with is below my belt, and generally this is not visible. But I did notice that I developed very fine paper thin wrinkles on my face during the process. These made me look like I was 100 years old. My wife suggested a product called Bio-Oil which is available at drug stores and walmart. I put it on my face each morning and the wrinkles were gone.

I am over 3 years post-op RNY gastric bypass surgery. At around 6 or 7 months, my weight loss stopped and I gently slipped into the Maintenance phase. This article describes my observations in the Maintenance Phase. http://www.breadandbutterscience.com/Surgery2.pdf

In many states there are bariatric centers of excellence. They are like one stop shopping. Everything is in one spot. Getting bariatric surgery can be a complex road. The insurance companies, the surgeon, the dietician, the psychologist, the hospital, the pre-op testing, the training. So it is good to get all the specialist in one place to deal with it. So you might search the internet for a bariatric center of excellence near you. They generally provide free seminars. You need to be in touch with your primary care physician to start the ball rolling.

I guess I never feel alone because I have myself. And my self keeps me pretty occupied. I am putting together an off grid solar array system this week. I put all the parts on the table and stare at them, read the instruction manuals, slowly like osmosis all the pieces seem to come together in my mind, and then I put it together and see if it works.

A search on the internet provided the following information: Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and noncompliance with a gastroplasty diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%. Although no unifying explanation for the etiology of anastomotic ulcers exists, most experts agree that the pathogenesis is likely multifactorial. These ulcers are thought to be due to a combination of preserved acid secretion in the pouch, tension from the Roux limb, ischemia from the operation, nonsteroidal anti-inflammatory drug (NSAID) use, and perhaps Helicobacter pylori infection. Evidence suggests that little acid is secreted in the gastric bypass pouch; however, staple line dehiscence may lead to excessive acid bathing of the anastomosis. Treatment for both marginal ulcers and stomal ulcers should include avoidance of NSAIDs, antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition, H pylori infection should be identified and treated, if present.

The three most important daily requirements after RNY gastric bypass surgery is to meet your daily Protein, Fluid and Vitamin requirements. food is secondary because your body is converting your stored fat into the energy that your body needs. Thus you lose weight. It is common for individuals to not be able to meet their protein or fluid requirements during the first few weeks after surgery because their body is in a major heal mode. For the first 4 weeks following surgery, my program requirements restricted me to Full liquids. This included foods that contain protein such as Yogurt (Greek yogurt has more protein) (but don't use the type of yogurt that has fruit on the bottom; low fat cottage cheese, Beans (except baked beans). Full liquids are defined as semi-solid or pudding like consistency. It is necessary following surgery to allow the staple lines in your stomach to heal and to prevent nausea and vomiting, so it is important to not rush into the pureed foods until week 5. But at 2 ounce per meal, it would be impossible for you to meet your daily protein requirement from food alone during this stage. I recommend that you experiment and then experiment some more until you find a protein supplement that you can tolerate. There are many types and I recommend that you try them all. I used a Protein powder called Muscle Milk Light (vanilla Creme) which I blended with Water and a half a banana. I tried using Isopure premix. It is extra high in protein but I couldn't stand the taste. But my wife liked it. There are protein powders that can be added to food. Also another way to achieve the protein requirement is to drink milk fortified with powdered milk. 8 ounces 1% milk plus 1/4 cup dry milk provides 14 grams of protein.

Congratulations.

The first few weeks after surgery, your body is in a major heal mode. Just remember to meet your daily Protein, Fluid and Vitamin requirements, walk around 30 minutes per day (or equivalent exercise).

Good luck.

Good luck and check back with us when you are on the other side.

Fitbit company and the Dana-Faber Cancer Institute are teaming together to investigate the relationship of breast cancer reoccurrence and weight loss. Too bad they did not include the one group of women who undergo weight loss surgery to successively achieve substantial and long lasting weight loss reduction. This Breast Cancer Weight Loss Study (BWEL) [is a 2 year study that] will include 32,000 overweight or obese women who have been diagnosed with early stage breast cancer. Each participant will receive FitBit devices: a fitness tracker that collects activity and heart rate information throughout the day; a scale that tracks weight, BMI, lean body mass and body percent fat, as well as access to proprietary software “which offers personalized video-based exercise experiences on mobile devices.” All these will link to an online dashboard to monitor progress and help the women stay on track. http://acsh.org/news/2016/06/29/new-investigation-will-examine-breast-cancer-recurrence-post-weight-loss/