James Marusek

Exercise is a combination of physical exercise such as walking combined with manual labor. For the first year after RNY gastric bypass surgery, I walked about 30 minutes per day up and down my driveway. It is a steep driveway and as a result it is more like hill walking. It uses two different sets of muscles, one going up and the other going down. If you are already walking between 8,000 and 10,000 steps a day, it sounds like you are already getting in your exercise. [How far is 10,000 steps? An average person has a stride length of approximately 2.1 to 2.5 feet. That means that it takes over 2,000 steps to walk one mile; and 10,000 steps would be almost 5 miles.] So you may be getting in more exercise than the minimum.

Hormones. You fat cells stored not only fat but also chemicals and hormones. As you lose weight, you release these hormones into your system and it can flood the system. By drinking fluids, especially filtered Water, you can flush these from your system through your kidneys. Eventually as you reach your lower weight, this will dissipate somewhat. So try and stay calm and remember hydrate.

Generally I eat an apple before bedtime. But you must eat the skin of the apple also. Here are some of the other suggestions made in past posts to deal with constipation: Smooth Move Herbal Tea Prune juice (warmed) Prunes (4 in the morning and 4 at night) Magnesium citrate Insoluble fibers (Garden of Life Raw Fiber or Renew Life Triple Fiber). Haribo sugar free Gummy Bears Aerobic Magnesium 07 Low Fat Bran Muffin (recipe). 80 calories each 1 cup flour 2 teaspoons baking powder ½ teaspoon baking soda ½ teaspoon cinnamon 2 cups bran Cereal 1 ¼ cups milk 1 egg ½ tablespoon applesauce optional: banana, berries, mini chocolate chips Bake 400° F for 22 minutes

I am almost 3 years post-op RNY surgery. This is my approach in the "Maintenance Phase". http://www.breadandbutterscience.com/Surgery2.pdf

The 30 minute rule does not apply to protein shakes.

Generally when I plateau midway through, it lasted about a week or two.

Congratulations.

I am 3 years post-op RNY. I found that generally above my waist, I am pleased with my body shape. It is only below my belt, that seems a bit deformed. Since this area is normally covered with clothes, I don't consider it a big deal. I went from a size 3XL in shirts down to a size small. I went form a size 46 in pants down to a size 32/33. I suspect that as you lose a little more weight, you may become a little happier and not need to consider plastics.

I am wondering why your PA prescribed Sucralfate and Reglan. Both are used to treat severe acid reflux (GERD). Prior to RNY gastric bypass surgery, I had severe acid reflux. As a result whenever I had an episode, I used over the counter Prilosec (omeprazole). After surgery, my surgeon prescribed the same drug for the first year. He said it was to allow my stomach to heal. I discontinued the use of Prilosec after the first year. I am 3 years post-op and my severe acid reflux has gone into remission. I am wondering if Prilosec might be a better alternative! My other thought is to ask if you took Probiotics after surgery to restore your beneficial gut bacteria.

The three most important requirements after RNY gastric bypass surgery are meeting your daily Protein, Fluid and Vitamin requirements. But the first few weeks after surgery, your body is in a major heal mode and it is hard to meet these requirements. So just keep trying and eventually you should get there. Protein - There are a variety of Protein shakes and protein supplements available. Experiment and find one you can tolerate. You don't have to like it, just tolerate it. I found that Muscle Milk Light (vanilla Creme) Protein powder blended with Water with a half a banana worked well for me. Fluids - This includes water, milk, the liquid you use in your protein shakes, the broth in Soups. After surgery my taste buds changed and I found water no longer tasted good. But with some experimentation, I found that Crystal Light worked. Later I began using fine English teas. Vitamins - Your body no longer synthesizes vitamins from you food, so unless you supplement your vitamins, your body will revolt. It is also important to get the right kind. My nutritionist does not allow gummy vitamins, so you may want to check to make sure that you select from the right options. If you are having problems tolerating Vitamin B12 sublingual tablets, there is alway the shots. One shot is good for a full month. But you will need a prescription called in from you surgeon's office. And you have to give that to yourself or one of your family members must give you the shot.

Generally, your body will determine when you slide from the "weight loss" phase into the "maintenance" phase after surgery. Goal weight generally is an arbitrary number. Normal (or ideal) BMI is defined as 18.5-24.9. When you look at mortality studies, individuals outside normal (either underweight or overweight) suffered from higher mortality rates. Therefore normal is ideal. In the end, I chose my goal weight closer to the high side of normal. This is because there is an advantage to have some fat on your body. When you suffer a serious injury or sickness, your body will rely on this fat to provide your body sufficient energy until you recover.

Congratulations.

I am almost 3 years post-op from RNY gastric bypass surgery. One of the reasons why I choose this type of surgery was because I had severe acid reflux (GERD). It is a very good type of surgery. It has been around awhile and it is almost a gold standard. Here is my experience. http://www.breadandbutterscience.com/Surgery.pdf

This has nothing to do with bariatric surgery but it was interesting. Researchers at the Icahn School of Medicine at Mount Sinai have studied the gene make-up of nearly 600,000 individuals. They were looking for individuals with resistance to any of the roughly 600 Mendelian disorders. These gene mutations normally result in severe grotesque and often deadly conditions such as Pfeiffer syndrome, where the skull bone fuses too early, and epidermolysis bullosa simplex, wherein one's skin becomes as fragile as a butterfly's wing. They found 13 individuals who had one of these genetic mutations but were resistant to the effects. Interesting! Now they are looking for other volunteers who would be willing to share their health and genetic data in order to identify what protects individuals against these diseases. They have set up a website called the Resilience Project to find volunteers for a follow on study. http://acsh.org/news/2016/04/21/superhumans-living-despite-having-fatal-genes/

Congratulations.

Good luck on your upcoming surgery. It is common to have the jitters before the surgery. Many do. In order to get you better prepared for surgery, I recommend 2 things. 1. Walk at least 30 minutes per day for now on. It will help the recovery process go smoothly and remove much of the pain you might experience after surgery, especially the gas pain. 2. If you haven't given up all caffeine and carbonated beverages, do so now. When I went cold turkey on my 6 diet coke a day habit I went through a week of caffeine withdrawal syndrome - severe headaches and body aches. It is better to get that over with now then compound it with the effects of surgery. Otherwise it is like a one two wammy.

Generally after surgery, you have so many wounds/scars that it is hard to find a comfortable position when you sleep. Some people sleep in a recliner for the first few days. I sleep in a Water bed, and trying to exit the bed was murder because of the pain. As time went on and the scars/wounds healed, it became more acceptable. As I lost the weight, I not longer had a fat cushion between my legs and I found that putting a pillow between my legs helped a lot. I think your nightmares/strange dreams may be due to your pain medication. It would be advantageous to get off this medicine as soon as you are able.

Great news! Congratulations.

I am almost 3 years post op RNY gastric bypass surgery. After surgery, my taste buds changed and Water no longer was appetizing. So I found other things such as flavored water (i.e. Crystal Light) to be acceptable. Later I began to drink fine English teas. Then as time went on I began drinking hot cocoa during the cold months. But one can only use the "no sugar added" variety. It is important to meet you daily Fluid requirements. So experiment until you find something that works for you.

Generally my dumping episodes were the result of eating too much volume of food.

I had Type II diabetes and was taking Metformin and Glipizide prior to RNY gastric bypass surgery. I am almost 3 years post-op. Two days after surgery, my surgeon took me off all my diabetes medicine and I haven't taken any since. My diabetes went into remission and has stayed there. I periodically check my blood sugar levels and they are fine without medication. One of the problems with continuing to take medication after your diabetes goes into remission is that the medicine might drive your blood sugar levels from being on the high side to the exact opposite - being on the low side. This is called hypoglycemia. So I think if you have concerns in this area you should consult your physician.

Congratulations.

I believe baby food in small glass jars can be acceptable during the puree stage. My surgeons directions actually listed "baby food fruits/vegetables" in the list of acceptable foods. But you have to read the labels. Many contain too much added sugar. Sugar need to be avoided. Before surgery, I bought a few jars in preparation. But I never used them. My taste buds changed too much after surgery. So I didn't even want to try.

The first few weeks after surgery, your body is in a major heal mode. So it will take a little time for the excess gas problem to ease up. After surgery, when you were in the hospital they pumped your body with fluids. Thus when you leave the hospital, generally you weigh more then when you first arrived. It takes a few days for you to lose this excess weight. Concentrate on meeting your daily Protein, Fluid and Vitamin requirements. food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. Your meal volume in the beginning will be incredibly small. Also at 4 days post-op, you should be in the full liquid state. Solid foods can damage your stomach while it is healing.

Generally in the full liquid stage, this can be Soups that have been strained from solids. Beef broth is a good example. In the puree stage, this can be soups that are blended in a blender. In the solid stage, this can be a can of soup with solids.