James Marusek

Many insurance companies require more than a weight history. They require that the patient takes action to try and reduce their weight through exercise and diet and was unsuccessful. And that this process is well documented. Many look at the patients BMI and the amount of obesity and also their co-morbidities. In many cases the insurance requires that the patient undergo a 6 month medically supervised weight loss program that includes diet and exercise. In many cases this is significantly stricter than provided by a general practitioner. But these requirements can vary from one insurance to the next. It is probably a good idea to begin attending Bariatric Surgery Support Group meetings. They are generally held monthly and are generally free.

This is a strange topic. It sounds a little like puppy-love. Having said that, I will admit that after writing to a girl on the other side of the world, I went to see her and proposed to her using a language dictionary after 6 weeks. (We didn't speak the same language.) I married her and we have been married for over 40 years now. I looked at it as a logical decision, not so much a romantic decision. We had many shared values. I am happy and I consider this to be one of the best decisions in my life. I experienced true adventure and now my children have a heritage like none other.

As your food volume increase, you have the option to reduce your reliance on Protein shakes, provided you consume high protein meals. Protein Shakes contain calories. When I started dropping off my protein shakes one by one, my weight loss picked up and I went off my stall. In order to do this, you will need to accurately assess the amount of protein you are obtaining from meals.

Congratulations.

Don't worry. It won't be until you reach the solid stage that you will notice the absence of hunger. In some cases, what individuals experience is described as head hunger. Many people report a strong desire to chew. When you are on full liquid and puree stage, you are not chewing your foods. Chewing is ingrained within us. Digestive fluids are released when we chew. It is a part of our normal eating process. Thus many people miss this function at least until they enter the solid stage. Time will pass quickly and you will be in the solid stage before you realize it.

Welcome Melanie. It is common for individuals to hit stalls after RNY gastric bypass surgery. So just be patient and the magic will happen. The three most important elements after surgery are meeting your daily Protein, Vitamin and Fluid requirements. food is secondary because your body is using stored fat and converting it into the energy that drives your body. Thus you lose weight. The important thing on Protein shakes is to experiment with the different types until you find one that you can tolerate. There are many different options out there, so just keep experimenting with them. I wrote a short article about my experience during the "Weight Loss" phase. Here is a link. http://www.breadandbutterscience.com/Surgery.pdf

I am 33 months post-op from RNY gastric bypass surgery. After surgery, the part of your stomach that process fats and sugars has been cut away and your stomach no longer processes these. They pass into your intestines and if you consume too much of these it will leads to dumping syndrome. But after about a year, your intestines begin to take up the slack and learn how to process fats and sugars. I had Type 2 Diabetes prior to surgery and took 2 types of diabetic medicine to control my high blood sugar levels. When I left the hospital 2 days after surgery, my diabetes went into remission and stayed there. But I became resolved to never let diabetes return. Thus I control my sugar intake like a hawk. One of the conditions that occur to some RNY patients is that they develop low blood sugar. This is despite the fact that they never had diabetes prior to surgery. This condition is called reactive hypoglycemia. This link will help you understand this condition. http://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/reactive-hypoglycemia/faq-20057778

Congratulations and good luck on your surgery. One word of caution. After I was approved and even had a letter from my insurance company stating I was accepted for surgery, I received a notice that indicated I still needed an additional approval. It turns out that I not only needed approval for the surgery but I also needed approval for the number of days I was to be hospitalized after surgery. I found this very confusing because how would the hospital know how long I needed to be in the hospital until after the surgery, since complications could extend my stay. I contacted the surgery team. They told me that it was just a formality and not to worry. I didn't and it was a non-problem.

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

Good luck on your surgery. I will pray that it is successful and without complications.

I had severe acid reflux (GERD). RNY gastric bypass surgery is the recommended surgery for patients with GERD. That is why I chose this option. Also RNY had one of the lowest revision rates. I figured that if I went under the knife once, I did not want to repeat it again and again.

Is this part of a rhyme "5 foot 2, eyes of blue". Need more info, like what type of surgery did you have? How much weight did you lose?

We live in a time when essentially our whole world (Earth) is known and everything has been explored. But if you stepped back a hundred years, the world was very different. It was filled with mystery and adventure. Years ago I read a book. It was called Sepoy's Daughter. The book didn't have a publication date or even an author. It is believed that the book was published in the 1860's. The author is given as "an eye witness". This link may get you in or get you very close. https://books.google.com/books?id=cMIwAAAAYAAJ&printsec=frontcover&dq=intitle:Sepoy's+intitle:Daughter&hl=en&sa=X&ved=0ahUKEwjsp_zq3NnKAhXDr4MKHeihCHgQ6AEIHTAA#v=onepage&q&f=false If you have problems, let me know and I will see if I can walk you to it.

I haven't seen any McDonalds or Pastry Shop advertisements on this website. So I cannot see what you are seeing. I do know that the internet has become rather intrusive in the last few years. If I perform a search using google on a topic, somehow that search then triggers a number of advertisements that become inserted into various websites. Then I also get a number of emails on the topic. So it may be the search engines that are triggering this type of advertisement. And as Samara1974 mentioned, you may be able to block this type of advertisement using the proper search engine and selecting blocks for pop-up ads.

Here is a photograph of the Chicago City Hall that was in the book. http://www.breadandbutterscience.com/ChicagoCityHall.jpg

I have a variety of hobbies. One of them is researching early American photographers. In the early days, books were published with illustrations that was until photographers became innovative. One of the first photographers to combine photographs into books was John Carbutt. He published a book in 1868 with almost 100 original photographs. It was called "Biographical Sketches of the Leading Men of Chicago". Approximately 500 copies of that book were published. In order to create that book, 500 photographs of each image was made from a negative and they were individually adhered to individual pages in each book. So the book was a collection of original photographs. Carbutt was a great photographer of his time and these photographs showed the quality of his work. Since these photographs were taken shortly after the Civil War, many of the individuals pictured in the book appeared in Civil War Uniforms. It is unfortunate that many of the copies of this book were destroyed in the Great Chicago fire.

Welcome and let us know if we can be of any help. I put my stories into a couple little articles on the internet. I am 33 months post-op RNY gastric bypass surgery. The first article covers my experience during the "Weight Loss" phase. The second describes the "Maintenance" phase. I have also included my before and after photograph at the 6 month mark. http://www.breadandbutterscience.com/Surgery.pdf http://www.breadandbutterscience.com/Surgery2.pdf http://www.breadandbutterscience.com/Operation.jpg

Around 20 years ago my dad died. My mom was a home body. His death affected her greatly and I was concerned she might decide to follow him soon. I told my mom to join some clubs because she needed contact in the outside world. She followed my advice and joined a book club and a church club. This helped her and allowed her to make some friends that followed her throughout the rest of her life. The second thing I did was to send my youngest daughter to live with her for the summer. My youngest daughter wanted to become a doctor and I figured the best approach was to have her work as a volunteer at a hospital during the summer so she could get some experience. She was in her early teens at the time and couldn't drive. And the hospital was close to my mom's house. So I felt it was killing 2 birds with one stone. My daughter would get some experience that could someday help in her career. My mom would get companionship, she would get purpose (driving my daughter to and from the hospital). It worked well that summer so we repeated it the next summer also. My daughter is a medical doctor today, in part because of this. So if I offer some advice, it is to get involved in some club or group. To begin with are you attending Bariatric Surgery Support Group Meetings? Generally they are free and are held once per month. But there are a variety of groups out there such as computer group meetings. Sometimes groups hold their meetings at libraries. That might be one place to look.

Congratulations - well earned.

Generally RNY gastric bypass is normally recommended for individuals with severe acid reflux (GERD) because sleeve can make the condition worse. I am 33 months post op RNY and I had GERD prior to surgery. GERD went into remission after surgery and stayed in remission since. I am not concerned about malabsorption for a couple reasons. First, because RNY surgery threw a number of my medical conditions into remission, I am no longer taking a variety of prescription medicine as I did before surgery. So the number of pills I take as Vitamins is about the same as the number of pills I took as prescription medicine prior to surgery and the cost is about the same. Second, I have yearly blood work drawn and they fine tweak my Vitamin requirements at that time. So I consider any malabsorption issue to be well monitored.

At the present time I am using Kroger's Children's Chewable Complete (which is suppose to be the equivalent for Flintstones Complete). It is cheaper than Flintstones but I find it has a chalkier tastes. It uses Aspartame as a sweetener, not sugar.

After surgery, the three most important elements are meeting your daily Protein, Fluid and Vitamin requirements. I hate the taste of Protein shakes. When I think of shakes I think of milk shakes and a Protein shake is anything but a milk shake. Having said this, it is still extremely important that you consume extra protein after RNY gastric bypass surgery. So the rule is to experiment at this stage. Try the various protein powders shakes, premixed protein shakes and supplemental powders that can be added to foods. Find something that you can tolerate. For me, I found that Muscle Milk Light (vanilla Creme) Protein powder blended with Water with a half a banana worked well. I used a Ninja blender with a single serving cup mixer. Your protein requirement is met by a combination of the protein that you obtain from meals combined with the protein from supplements (protein shakes, powders, protein bars). In the beginning your food volume is so minuscule that you are unable to meet the daily protein requirements from meals alone. Eventually if you concentrate on high protein meals, when your meal volume increases you will be able to start to reduce your reliance on protein shakes. I am 32 months post-op and I no longer take any protein supplement because I can pull all the protein I need from meals alone. Also in around another month or two you will be able to transition to another option which is Protein Bars. I used Quest bars especially when I was away from home.

Good luck on your surgery and let us know how it went when you are on the other side.

For the first few weeks your body is in a major heal mode and it takes a little time for things to kick off. During the hospital it is common to gain some weight because they fill your body with fluids and it takes a little time to loose this new weight. It is also common to hit stalls. The three most important elements after RNY surgery it to meet the daily requirements for fluids, Vitamins and Protein. Also walk for 30 minutes per day. So be a little patient, follow the requirements and let the magic happen.

It seems like the recommendations for RNY gastric bypass and Duodenal Switch surgery patients appear to be those that my surgeon follows. Supplementation after gastric bypass should include calcium citrate 1,200–1,500 mg/d, which can be taken in 2–3 split doses, 4–5 hours apart for optimal absorption. Minimum Vitamin D intake of 3000 IU/d, titrate to >30 nl/mL. Calcium citrate is preferable to calcium carbonate due to better absorption in the absence or reduction of gastric acid. Supplementation after BPD and BPD/DS should include calcium of 1800–2400 mg/d and minimum Vitamin D 3000 IU/d, titrate to >30 nl/mL. After RNY and Duodenal Switch, there are a lot of Vitamins required daily. The calcium tablets are a major inconvenience because they taste terrible (just like eating chalk), must be spaced apart throughout the day and one has to take so many of them. As a result, I had one individual in our bariatric support group meeting say they were no longer going to take Calciums. I even cut mine back a little. But when I had my annual blood tests, they found I was on the low side and recommended that I take more Calcium. THEY GOT ME. I WAS CAUGHT. So I went back to their required dosage rates. I guess the main point is that after these types of surgery, the requirement to take supplements span for the rest of our lives - PERIOD, NO EXCEPTIONS.