James Marusek

This article describes my approach in the Maintenance Phase. http://www.breadandbutterscience.com/Surgery2.pdf

So what are the tips?

I had to do a 6 month. The whole process from beginning to surgery was around 9 months. So hang in there. It will go by fast.

One of the surprising motivators for me were clothes. I would buy a pair of jeans or a new shirt that was extremely tight. I generally had to take a deep breath in order to put it on. And then the next week almost like magic, it would fit like a glove. It is one of those intangible Non scale Victories (NSV).

Many people report experiencing a drop in shoe size. For many it is the width of the shoe but some also experience shorter sizes.

I am 32 months post-op RNY gastric bypass surgery. I lost quickly after surgery, some days it was 2 pounds a day and then after a couple months it started to tapper off. My weight loss phase transitioned into a maintenance phase around the 7th month. But different individuals experience different losses. It is common to experience a stall or two along the way. Some individuals just have more weight to lose. Generally focus on meeting the Protein, Fluid and Vitamin daily requirements. food is less important. Your body will be converting stored fat into the energy that drives your body, thus you lose weight. Walk 30 minutes per day. And let the magic happen.

One individual in our bariatric surgery support group was in the final preparations for RNY surgery. He underwent the pre-op testing and a surgery date was set. He was a week away from surgery but then they called him in for immediate surgery - open heart surgery. He was about to have a heart attack. We saw him at the next meeting after his heart surgery, he had lost some weight and then few months later he had regained enough strength and then underwent the RNY surgery.

After surgery, my taste buds changed and many things that I liked to eat before surgery became intolerable. I don't like to drink Protein shakes. To me the term is a misnomer because it sounds like a milk shake and it is anything but a milk shake when it comes to taste. Having said this, it is extremely important that you experiment and find a protein supplement that you can tolerate. That is an important word "TOLERATE". It doesn't mean that you have to like it, only be able to drink it. So let's discuss protein shakes. They come in powder form and premixed. I went with the powder form. I used Muscle Milk Light (vanilla Creme) powder. Flavoring is important. I loved chocolate prior to surgery but not after. I found that I could not hand mix the powder - it would clump together and taste terrible. So I bought a blender. For me a Ninja blender with a single serving cup worked very well. Later I found that I could blend in a half a banana into the Protein Shake and it increased the flavor. In the long term you will be able to get off the protein shakes as your meal volume increases - if you concentrate on consuming high protein meals. But NOW you are defeating the surgery and your potential weight loss goals. Also there are so many different types of protein shakes available, you need to experiment and try the different compositions and flavors available. There are also protein powders that can be added to meals to up the protein content.

I don't remember seeing any but the exact opposite may be true. Many cancers feed off sugar. If you reduce the sugar level in your diet, such as those that undergo WLS, it should reduce the spread of cancer.

Take extra Vitamin C. Also Vitamin D may increase the ability of your immune system to ward off infections. Echinacea shortens the duration and reduces symptoms of the flu. Elderberry has a long history of use for the treatment of upper respiratory infections. Goldenseal supports normal immune system functions, kills bacteria, and prevents flu virus growth. If you want to try essential oils, you might try a blend such as Raven, Thieves, Melrose, Australian Blu, Purification, ImmuPower, Sacred Mountain, R.C., Exodus II. Generally on these essential oil blends, you apply a dab on your wrist and rub your wrist together. The oils are absorbed through your skin into your blood stream within about 8 minutes and you begin to feel the medicinal properties begin to take hold. You can do this several times per day. Some of the blends contain oils that are photosensitizing (they can change your skin color when exposed to UV radiation). Apply those to the soles of your feet. And follow any safety precautions listed. I have not tried any of these. I make my own blend and my blends seems very effective. You can probably find some of these blends at health food stores.

I am 32 months post-op RNY surgery. Several months ago, my wife suggested that I try the essential oils (medicinal properties). So I did. It's a little like becoming New Age in my Old Age. But I haven't started wearing Hippy Beads around my neck yet. So if you were New Age, you would realize that your body periodically needed cleansing. They would call it detoxification. Many of the hormones and toxins that were trapped in the fatty deposits in your body have been released as you lose weight and your body needs to eliminate and expel them, flush them out. Proper Water is important for efficient elimination of wastes and toxins. Sufficient water stimulates the kidneys and liver, both organs of detoxification. Their definition of proper water is not tap water but rather filtered water or optimally distilled water. They would also say that some essential nutrients and minerals aid in the detoxification process, for example choline, molybdenum, sulfur. Physical activity accelerates the body's natural detoxification process. I guess to make a long story short, you might try visiting a health food store and tell them you would like to detoxify your body because you are experiencing significant weight loss. They will probably lead you to some concoction such as Sonne's No. 7 Detoxificant, buy it and try using this for a while and see if it helps. Also use distilled water for awhile and make sure you do your daily exercise.

I don't really try. I am 32 months post-op RNY. If I find something that I can eat at a fast food restaurant, it becomes my standard. I go there and order it ALL THE TIME. The chili at Wendy's is good. A crunchy taco at Taco Bell is good. A half of a French Dip sandwich at Arby's is good and I take the other half home for leftovers. For a while, Olive Gardens had a small plate menu which contain Tortelloni al Forno. This made a wonderful meal which was around $4. So I look for great meals, small volume and within my dietary requirements. Recently I came across a small mom-and-pop restaurant called Judy's Kitchen in the mall's food court. It is a strange name for a restaurant that is a Korean restaurant. They serve a simple fantastic bowl of Won-Ton Soup for around $5, so whenever I am in town I go there for lunch.

Put blinders on. I ran into a lot of problems along the way with my insurance. They did very unusual things. I went through a 6 month medically monitored weight loss program. They paid for my doctor visit for the first month but not the second month. When I asked them why they didn't pay, they said weight loss is not covered by my plan. They paid for the 3rd month visit but not the 4th. I contacted my insurance and they said they made a mistake but not to worry, they would not ask me to repay them. They paid for the 5th visit but not the 6th. I just put blinders on and charged ahead. I figured this was just some game the insurance companies played to make sure I was really committed to this process. If you encounter roadblocks, just keep trying to go forward, until they give in.

It is common to experience stalls during your weight loss journey. The important thing to remember is meet the Protein, Fluid, and Vitamin daily requirements. Do some exercise. Do not exceed the meal volume limit. And then let the magic happen!

I'm not surprised. People are people and doctors are no different. My general practitioner has smoked cigarettes for years. He probably knows it could well lead to cancer but he continues to smoke. Many doctors are specialized in a field, but are not universal experts. They see the micro but not the macro (the big picture).

I eat popcorn but I am 32 months post-op RNY. I would not suggest you use it until one year post-op. It is so important to maximize your weight loss in the beginning.

Congratulations.

The strategy during the "Maintenance" phase is different than during the "Weight Loss" phase. The following provides my experience with the "Maintenance" phase. http://www.breadandbutterscience.com/Surgery2.pdf

After surgery most foods seemed to lose their taste. Eventually I found out that mixing foods together seemed to add flavor back into my meals. So I generally relied on softer foods such as chilis and Soups.

After RNY gastric bypass surgery, your body needs some time to heal before you subject it to solid foods. That is generally 9 week post-op. Two weeks post-op is way to soon to experiment with solids. After RNY gastric bypass surgery, your body needs some time to heal before you subject it to solid foods. That is generally 9 week post-op. Two weeks post-op is way to soon to experiment with solids.

I had high blood pressure, type 2 diabetes, severe acid reflux (GERD), sleep apnea and other medical conditions. All of these went into remission within 2 weeks after surgery and have stayed in remission. I am 32 months post-op. So all I can say is having RNY gastric bypass surgery was the best decision I ever made.

Generally after RNY gastric bypass surgery, one is restricted from eating solid foods until the 9th week. Your body needs to have time to heal before you subject it to solid foods. I do not think I regretted the surgery. But it took 6 months before I reached a "happy state" when all the problems that I encountered after surgery seemed to be resolved.

A couple of new reports in JAMA Surgery shed some light on the impact of bariatric surgery on remission of Type 2 diabetes. One report focused on data from about 570 people who had undergone some type of bariatric surgery between 2005 and 2012, who also had Type 2 diabetes (T2DM). All had started with a BMI of 35 or more (morbid obesity — standard eligibility for such surgery). These folks were matched with diabetic patients who had not had surgery (1880 people), but were otherwise similar in terms of age when the operated people had surgery, sex and BMI. The main focus of the study was the extent to which T2DM remission occurred, and whether the level of hemoglobin A1c, or HbA1c, (a measure of long-term blood glucose control) decreased to less than 6.0 percent (any HbA1c over 6.5 percent is considered diabetes). The investigators, led by Dr. Jan Peter Yska from the Medical Centre Leeuwarden, Leeuwarden, the Netherlands reported that 95 (out of the 570) persons with T2DM who underwent surgery were in remission compared to only five patients in the non-surgical group (1880 total). The results also depended on the type of bariatric surgery involved. Gastric bypass surgery was the most effective, followed by sleeve gastrectomy and then by gastric banding (for more information on the types of bariatric surgery, read here). Thus, the researchers found, the positive effects of bariatric surgery could be seen for at least two years post operation. Although the standard cut point for bariatric surgery is usually a BMI of at least 35, some have queried whether or not such surgery would also benefit diabetes patients with lower BMIs. This question was investigated by Dr. Chih-Cheng Hsu from the China Medical University in Taiwan and colleagues. They examined records of 52 diabetic patients who received bariatric surgery — either sleeve gastrectomies or gastric bypass — and compared them to records of 299 T2DM patients whose conditions were managed medically. All patients had BMIs lower than 35. By five years post-surgery, the operated group had lost 21 percent of their initial body weight, bringing their BMIs down from about 31 to 24.5. In addition, their average HBA1c levels dropped from 9.1 percent to 6.3 percent over the same period. Thirty-six percent of this group had complete remission of their T2DM. In contrast, only one person in the medically-managed group, had a complete remission of their disease, and their HBA1c was, on average, 8 percent — still in the diabetic range. All differences between surgical and control groups were statistically significant. http://acsh.org/2015/12/bariatric-surgery-linked-to-diabetes-remission/ I suspect on the first study, the reason why the remission rate is so low is because they are lumping lap band patients in with RNY and sleeve patients.

It helps if you sleep on your side to put a pillow between your legs, especially after you lose some significant weight.

It is common to encounter stalls after gastric bypass surgery.