James Marusek

Congratulations

I began attending Bariatric Support Group Meeting. They are generally held once per month and are free. I began walking 30 minutes each day. Walking really helped to make the recovery process go smoothly and quickly. I gave up all caffeine and carbonated beverages. I had a 6 Diet Coke a day habit and making this one change caused me to drop 20 pounds. I had to suffer through a week of withdrawal syndrome because of the caffeine. But it was far better to go through this early then combine it with the recovery process after surgery.

Within life there are trade-offs. Generally there are two sides to a coin and it is good to look at both sides. For me, having RNY was one of the best decisions I ever made. I had to trade "my love of food" for "good health" and I made the right decision. If you want to see my impression of the process (I am 30 months post-op) here are a couple articles which I wrote about the process. I will also give you a link to a before and 6-month post op photo. http://www.breadandbutterscience.com/Surgery.pdf http://www.breadandbutterscience.com/Surgery2.pdf http://www.breadandbutterscience.com/Operation.jpg

After RNY surgery, I completely lost my appetite. I found it difficult to eat hard foods, such as steak and chicken. I found that eating softer foods such as chili and Soups worked well for me. I have included a few recipes in the following article. http://www.breadandbutterscience.com/Surgery.pdf

Many people who undergo bariatric surgery suffer from a type of hypoglycemia (low blood sugar) called Reactive Hypoglycemia. This article will explain the condition. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/

Generally setting a weight goal is an arbitrary number. Generally morbidity studies show that individuals that are underweight or overweight have a higher mortality rate. Those people who are in the normal weight category with a BMI of between 18.5 to 24.9 live longer. But when you get a serious illness or accident, you may lose weight and this can lead to death. Therefore I have set my goal near the 24.9 BMI which gives me a little bit of energy reserve (in the form of fat) should I have a major illness or accident.

Many times during surgery you are administered antibiotic to prevent you from getting an infection in the hospital. These antibiotics kill not only the bad bacteria but also the good bacteria in you body. Therefore it is a good idea after surgery to take probiotics for a week or so to restore the lost good bacteria.

Congratulations on the 37 pounds that you lost thus far. It is common to encounter stalls. It appears that you are about 1 to 2 months post-op at this point. If you are encountering nausea frequently and find it difficult to consume even small volumes of food, it may be because of a stricture. Otherwise, just continue to follow the requirements of the program (Protein, fluids, Vitamins and meal volume). As your meal volume increases, if you concentrate on consuming high protein meals, you will be able to begin to drop off your protein supplements. These supplements do contain calories. Your daily protein requirement is the sum of the protein you consume from meals combined with the protein from supplements (Protein shakes, protein bars). Reducing you dependency on supplements can kick-start your weight loss from a stall.

Your body is in a heal mode at the moment. Do your best to follow the daily recommended Protein, Fluid and Vitamin requirements and things should get better. It took me around 6 months to reach my "happy state" when all the minor problems were resolved.

The goals of the "Weight Loss" phase and the "Maintenance" phase are different and they require different approaches. Perhaps this article can explain. http://www.breadandbutterscience.com/Surgery2.pdf

I never heard of schizoaffective disorder so I looked it up. It is referred to as a combination of schizophrenia and mood disorder - either bipolar disorder or depression. Several individuals with those types of mood disorders have undergone WLS and have posted on this website. As others have already said, talk to your surgeon, be open, and see what they recommend.

My nutritionist recommended Quest Protein bars. One of the advantage of Quest, other than the fact that they come in a variety of flavors, is that they contain fiber. I was having issues with constipation at the time. This is a good approach.

Congratulations

Stay calm. It is common to take a few weeks before you begin to lose weight. Your body is in a major heal mode and allowing it to heal is the prime goal at 10 days post-op. For one thing most patients gain weight while they are in the hospital because they are pumping fluids into you. So you have to first lose this added weight before you begin to see a weight loss. So stay calm, follow the directions (meal volume, Protein, fluids and vitamins), relax and let the magic happen.

I had a problem with scales too. I would step on it in the morning and then again a few minutes later and get two entirely different set of numbers. Sometimes the numbers would vary by several pounds. Couldn't believe the numbers, so I literally threw the scale out and began looking for something a little more consistent. I found a scale that gave readings in increments of 0.2 pounds and was repeatable. It was a Beurer Model Number BF66. I bought it at Bed, Bath and Beyond. [it has an upper weight limit of 330 pounds.] I have used it for 3 years now and am happy with it. Your weight can vary by as much as 5 pounds during the day. I weigh myself naked first thing in the morning. This is generally my lowest weight. Adding clothes, watch, wallet, shoes can add around 4 pounds. [That is why the scales in the doctor's office can add a few pounds to my weight.] When I eat, I can add some more. The main thing I am looking for is consistency and accuracy.

Congratulations on your weight loss thus far. I had RNY and transitioned from the "Weight Loss" phase to the "Maintenance" phase around 6 or 7 months post-op. Gastric Sleeve patients tend to lose weight slower but over a longer period of time than RNY patients. Generally I don't track calories but rather food volume. This article describes my experience with RNY. http://www.breadandbutterscience.com/Surgery2.pdf I am older and less active, so my caloric intake is substantially lower than yours. Immediately after RNY surgery, my caloric intake was around 400 calories per day for several months. So long as I met the Protein, Fluid and Vitamin requirements, I was fine. So when I hear that "1700-2500 calories to lose weight safely", that is not my experience.

Generally, the health insurance companies are the ones that dictate medically supervised diet and exercise programs as a prerequisite. Surgeons are more focused on the success of the surgery. This means Psychological testing, Pre-Op testing, the ability to follow the program requirements after surgery, a training class that lays down the program requirements in great detail, also some pre-op weight loss to make your stomach a little looser so the surgeon can perform the operation effectively. This can all take time. It gives you the opportunity to attend some Bariatric Surgery Support Group meetings and get in the habit of exercise. Thirty minutes of walking each day will make the recovery process go smoother and less painful.

In my experience with RNY surgery, my weight loss slowed and stopped and I smoothly transitioned into the "Maintenance" phase. This happened around 6 or 7 months post-op. In general, my goal was to maintain my weight at the high side of normal BMI. Generally normal weight is defined as 18.5-24.9 BMI. I personally believe that it is good to have a little extra fat on my body so I can survive a major illness or injury when one has a tendency to lose weight. So my goal is close to 24.9. I have dropped as low as 23.1 just as an experiment. With a BMI of 20.3, you are still within "Normal". Sometimes I find it difficult to eat food even at 30 months post-op. If I consume too much volume, it can lead to dumping. I mentioned this to the nurse of my surgeon. She said my surgeon has a tendency to make the pouch small and that they can perform a simple procedure to enlarge it slightly. I am happy where I am at and didn't pursue the subject any further. I think it is the same procedure for dealing with strictures.

Generally I had a half a banana blended in with my Protein shakes. Stalls are a common occurrence. The three most important requirements after surgery are meeting your 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. Just concentrate on meeting and not exceeding your meal volume requirements and let the magic happen. Sometimes medicines can interfere with weight loss. At 2 months post-op, your meal volume is just beginning to increase. If you concentrate on high protein meals, it means that you can begin to reduce your reliance on protein supplements (Protein Shakes, protein bars) and the calories they contain. This can help you break out of stalls. Remember your daily protein requirement is met by the protein you obtain from meals combine with the protein from supplements.

Good luck on your surgery. I basically told everyone even strangers on the street. Most people were either supportive or curious. But then again I don't suffer from the stigma of going through too many yo-yo diets. (Lose weight only to gain it back and then some.) It's your decision who to tell.

Beans! http://www.healthaliciousness.com/articles/beans-legumes-highest-protein.php

There was an interesting study done by Dr. Guenther Boden of the Temple University Medical School in Philadelphia and colleagues recently. They confined six normal-weight men to hospital beds for a week, encouraging them to stuff themselves with food — to the tune of 6,000 calories per day. Their objective was to investigate the genesis of obesity-associated insulin resistance. This study seemed to show that increased oxidative stress was related to acute obesity onset. And the researchers suggested that a Protein, the GLUT4 glucose transporter, was affected by the excess of reactive oxygen species. This protein is produced by fat cells after insulin stimulation, and provides the means by which glucose is taken up from the blood. Obviously, if GLUT4 isn’t functioning properly, blood glucose levels will be adversely affected. Refer to http://acsh.org/2015/11/6000-calorie-diet-yields-clues-to-insulin-resistance/ Maybe, I'm a little off here but it seems to me that an interesting follow-on study should look at the opposite state. There is a large pool of individuals undergoing RNY surgery. They drop a lot of weight, they halt the progression of obesity and in many cases their diabetes goes into remission and it does so within days. Maybe tracking the GLUT4 levels in these patients might give the researchers a large pool of data to put a nail into this research.

I'm a little lost. Pre-op 304 pounds, present weight 276 pounds. That is a weight loss of less than 30 pounds. But you are showing a weight loss of 64 pounds. Did you lose over 30 pounds during the pre-op phase or is your ticker just wrong? If all you lost was 30 pounds over 2 months, I think I can understand why you would be disappointed. The only advice I can offer is to follow the meal plan (volume), take the required Protein (make sure the protein supplements have minimal calories), and be patient. Discuss your problems with the nutritionist and see if they can figure why the minimal weight loss.

Interesting discussion. Before I had WLS, I was obese and one of the problems I had was eating at restaurants. If I ate at a booth, invariably, food would find their way onto my clothing. It was messy. If I ate at a table, I didn't seem to have that problem. It wasn't an issue of feeling comfortable. It was more of an issue of whether I needed to bring along an extra set of clothes to change into after the meal or go directly home afterwards.

Strictures occur in about 5-20 percent of gastric bypass patients. They usually occur several weeks to months after surgery. They can be managed with endoscopic dilation. An endoscopy or upper GI tests will help with the diagnosis.