James Marusek

The three most important things after surgery are to meet your Protein, Fluid and Vitamin daily requirements. food is secondary because your body is converting stored fat into the energy that drives your body. Thus you lose weight. As far as protein, one needs to experiment until you find a form of Protein shake or powder that you can tolerate. It seems you have done that. Your surgeon and nutritionist should have defined the minimum amount of protein you must consume each day. That is your daily requirement. It is best to take this protein spread out throughout the day, otherwise your body may not absorb it. Some forms of Protein drinks have 45 grams per drink and if you drink this all at the same time, this can be problematic. When you get a few months post-op, you will have another option open up for you. These are called Protein Bars. They come in very handy when you are on the go. Also as your meal volume increases, you will have the option of reducing your reliance on protein supplements, that is, if you concentrate on consuming high protein meals. Your protein requirement is met by the combination of the amount of protein you consume from meals combined with the amount from supplements (protein shakes, protein bars).

Most individuals have a strong desire to chew. It is part of our digestive process. For the first 2 months after RNY surgery, our diets are restricted from solid food and as a result - no chewing. This is to protect the stomach from damage during the healing process. This first two months went by so quickly, I do not remember a strong obsession with chewing. So all I can say is this time is short and very soon you will again be able to chew.

According to your other posts, your surgery was done laperscopic 5 days ago. There are different kinds of pain associated with RNY Gastric Bypass surgery. One kind of pain is gas pain. Walking significantly decreases this type of pain. For most individuals this type of pain disappears within the first 7 days after surgery. Then there is the rawness at the incision points. I would describe this type of pain as tenderness or soreness. This is amplified by the fact that you take blood thinner injections for around the first week or two after surgery to inhibit the formation of blood clots. This causes your body to bruise very easily. Pain can also be an indicator of an abnormality, for example blood clots. Risks common to all surgeries for weight loss include an infection in the incision, a leak from the stomach into the abdominal cavity or where the intestine is connected (resulting in an infection called peritonitis), and a blood clot in the legs (deep vein thrombosis, or DVT) or lung (pulmonary embolism). These conditions should be brought to the immediate attention of your surgical team. Refer to your discharge instructions. Mine read: 1. Medication intolerance. 2. Temperature greater than 100.5 degrees F. 3. Uncontrolled or increased abdomen pain 4. Shortness of breath or calf pain (possible signs of blood clot). 5. New onset of upper back or left shoulder pain. 6. Chest pain, rapid heartbeat and/or dizziness. 7. Changes to your incision - new pain, swelling, redness, cloudy drainage. 8. Inability to eat or drink. 9. Persistent nausea or vomiting greater than 6 hours. 10. Persistent diarrhea beyond the first week after discharge or more than 6 diarrhea stools in a day. Diarrhea is normal after surgery. 11. Cloudy output in or around drains.

It might be the creamer rather than the coffee that may be causing diarrhea. Most creamers contain a significant amount of sugar or other sweeteners. For RNY patients this can quickly lead to dumping syndrome, I am not sure for sleeve patients.

One of the requirements for RNY surgery was to give up caffeine and carbonated beverages. I went cold turkey when I began my 6 month medically supervised weight loss and exercise program. I suffered through a week of severe withdrawal syndrome one I went off the caffeine. This withdrawal symptoms included severe headaches and body aches. If I had waited until just before surgery to do this, the effects would have been compounded with the after effects of the surgery making it a double whammy.

Generally if you have severe acid reflux (GERD), then RNY is preferred over sleeve.

It is common to feel cold after WLS. Fat is a good insulator. As you lose fat, that insulation layer is gone and you will feel cold. Whenever I shovel snow, I now know how good hand warmers are. They are almost essential. When a person is overweight, many times they have existing hernias that they are unable to detect because they are overweight. So hernia operations are common for those undergoing WLS. Before I had WLS, I had two hernia operations. They were spread around 10 years apart. I do not remember pain being associated with these hernias. When I coughed, I could detect them. I suspect that if you are feeling pain, these are more severe and need to be corrected through surgery. If you are getting sleepy after meals, it may be due to low blood sugar, a condition called reactive hypoglycemia. Several individuals that underwent RNY surgery experienced this condition. I do not know if it is common for sleeve patients.

I am 32 months post-op RNY gastric bypass. One of the interesting things that happened after my surgery was that I completely lost my hunger. It was not difficult to lose weight when hunger is not constantly continually gnawing at your bones. Many individuals that undergo RNY experience this loss of hunger. This condition does not last forever but after a year or two the hunger returns but not at the same level. RNY is the best approach for those with GERD. I had severe acid reflux (GERD) prior to surgery. But that condition went into remission after surgery. I have experience dumping syndrome. But once you go through it once, you become aware of the signs and stop before you reach that state. So for most people it is not a significant problem. I keep up on my Vitamin regiment. Since I undergo blood work about once a year any deficiencies are noted and my vitamin regiment is modified for any deficiency. Life is full of trade-offs. I traded my love for food for being healthy. My diabetes, high blood pressure, GERD, sleep apnea and several other conditions went into remission within days after surgery and have stayed in remission.

I used Muscle Milk Light (Vanilla Creme) protein powder for my protein shake. I used a Ninja blender (single serving cup) to mix the powder with water to make the protein shake to get the right consistency. If you can tolerate milk that is another alternative for protein. For the first couple months after surgery I became lactose intolerant, so that option was unavailable to me. During the cold weather, I found that a cup of hot cocoa (No Sugar Added) variety worked for me. This article may be of help. http://www.breadandbutterscience.com/Surgery.pdf

So you had your lapland removed almost a month ago. Did you have a revision? Were there complications with the band? How can we help you?

I haven't tried these sugar free cough drops but I don't think it would harm you. You might also try herbal teas that are specific for cold and flu symptoms.

I had RNY gastric bypass surgery 32 months ago and it was one of the best decisions that I ever made.

I am not sure what you mean by Stage 4. It is important to allow your stomach to heal properly after RNY gastric bypass surgery. Some people push to solid foods too early and run into problems. At 1 month post-op, you should be in the puree stage, not solids. Solids becomes an option at the 2 month mark. If you are trying to eat solids, you may be pushing it and it can result in you throwing up. The most important elements after surgery are meeting your fluid, protein and vitamin requirements. Food is secondary. You will not starve. Your body is converting your stored fat into the energy that drives your body. It sound like you are having problems in all three areas and this may account for your weakness. Taking probiotics is also a good idea. When you were in the hospital for surgery and also 2 weeks later, they probably gave you antibiotics. The problem with antibiotics, is that it kills not only the bad bacteria but also the good bacteria in your gut. Probiotics restores the good bacteria and allows your stomach and intestines to process food normally again.

Around the 6 month mark, I hit the point where all the many problems associated with RNY gastric bypass surgery, were resolved. I hit my Happy State.

I know nothing about this medicine, but these links may be of help. http://www.obesityaction.org/educational-resources/resource-articles-2/weight-loss-surgery/i-am-a-bariatric-surgery-patient-which-medications-are-recommended-and-which-ones-should-i-avoid https://asmbs.org/patients/life-after-bariatric-surgery http://www.medscape.com/viewarticle/545489_6 Probably the best advise I can give you is talk it over with the bariatric surgeon's office.

Daisee68 said "And correct me if I am wrong @James Marusek, but have you said recently that the malabsorption does eventually taper off?" After surgery, the part of the stomach that process fats and sugars is cut away, and as a result consuming fats and sugars can lead to dumping. But after a year or so according to my nutritionist, the intestines will begin to perform this function and this type of malabsorption goes away. But the ability of the body to process food to create Vitamins does not go away. This type of malabsorption continues for the rest of your life.

Congratulations.

I am 32 months post-op RNY gastric bypass surgery. Before surgery, I had severe acid reflux (GERD) along with a number of other medical conditions such as high blood pressure and diabetes. These conditions went into remission within days after surgery and remained there. If you have GERD, bypass surgery is generally the recommended approach. If you have the sleeve with this condition it can make the condition worse. Several individuals on this board had sleeve and because of GERD had to have a revision to RNY gastric bypass. I do not find that the malabsorption issue is a problem. I take a lot more Vitamins now after surgery but their cost is offset by the fact that I am no longer buying prescription medicine for my other conditions that went into remission. I think it may in all likelihood be the exact opposite. After surgery, they periodically require a complete blood workup. This nails any malabsorption issues. The Vitamin regiment is modified after these tests to correct any malabsorption issues. So my body is probably better tweeked than before surgery.

I am 32 months post-op RNY surgery. This is the approach that I used during the "Maintenance" phase. http://www.breadandbutterscience.com/Surgery2.pdf

Nothing wrong with engineers. Several months after surgery as the weight dropped off, I began getting comments that I was looking too thin. Some people even compared me to the survivors at Auschwitz. I wasn't too thin but I looked too thin. As I lost weight, I still tried to use the clothes that I owned. My suits, jackets and coats were the last to go. When you lose weight it is not only at the waistline but also from shoulder to shoulder. So all my suits, jackets and coats were now way too long at the sleeves. I looked like Dopey in Disneyland cartoons. This gave me the appearance of being too thin. It is perception. Clothes can make a significant contribution to your new appearance.

Congratulations and I wish you well in your journey through life.

When I went in for my pre-op testing, they found a few issues that needed a second round of testing conducted by specialists in their respective fields. This is common. I underwent a one hour ultrasound exam that showed my blood vessels were relatively clean. A CT Scan that showed there was a large mass in one of my lungs. It turned out to be nonmalignant. I also went to an examination with a Pulmonologist that showed I had sleep apnea. So long story short. You are nearing the end of your long journey.

Good luck on your doctor visit.

Congratulations.

It does take a little time to get over the surgery. It took me about 6 months to reach my happy state when all the problems were resolved.