James Marusek

At 9 months, your allotment for meals has increased significantly. At this point if you were concentrating on consuming high Protein meals, you should be able to reduce the number of protein supplements (Protein shakes, protein bars) that you are taking (and the calories associated with those supplements).

Congratulations on your weight loss. 242 pounds is impressive.

Do you suffer from acid reflux? Are the shakes you are taking called Bariatric Advantage High Protein Meal Replacement Shakes? I haven't used this product but the description looks like it would be good to go. [The Bariatric Advantage High Protein Meal Replacement contains 150 to 160 calorie serving provides a full 27 grams of protein, with only 7 grams of carbohydrate (of which 5 grams are Fiber, and only 1 gram is sugar) and a 1.5 grams of fat.] Since you are taking 5 shakes a day, you are trying to replace 5 meals a day. Are these shakes a small amount of powder at the bottom of an empty bottle that you just add Water to and shake? If you are suffering from acid reflux, you might try taking Prilosec. It should probably work better than antacids.

It is common for people to hit stalls during the process. Right after surgery, the most important requirements are Protein, fluids and Vitamins. Meals are secondary because your body is converting your fat into the energy that drives your body. Thus you lose weight. I had RNY gastric bypass surgery. The prescribed meal plan for the first 8 weeks post-op was 3 meals per day which were 4 tablespoons in volume each. Surgeons may differ in what they prescribe for meal plans.

Many people experience a fear of failure when it comes to weight loss. This is cemented into their minds by the failures they experienced by years of "yo-yo" dieting. RNY gastric bypass surgery is a whole different experience. After surgery I completely lost my hunger. I found that it was not hard to lose weight when hunger was not constantly and incessantly gnawing at my bones. Back to your problem, weight gain during the pre-op stage. Here are some recommendations: Begin attending Bariatric Surgery Support Group meetings. They are generally free. Walk 30 minutes every day. Give up all carbonated beverages. I lost 20 pounds on giving up my 6 diet Coke a day habit pre-op alone. Read the calorie labels of everything you consume, especially at fast food restaurants and try and pick low calorie foods. I use to love milk shakes at "Steak and Shake" but after reading the number of calories in a milkshake, I gave that up for life. On the other hand a crunchy taco at Taco Bell isn't bad nor a bowl of chili at Wendy's.

You have a family history of GERD. In general RNY gastric bypass surgery is normally recommended for GERD patients because a sleeve will only make the condition worse. RNY has a longer track record than sleeve. It has been around longer. Generally the surgeon leaves the decision of which type of surgery to the patient. But they do make intelligent recommendations. So if the surgeon is pushing sleeve, listen to his arguments and then make up your mind.

After surgery and during the hospital stage, many people gain weight because they fill your body with I.V. fluids. Therefore when you finally arrive home, you will need to lose that weight first before you see any weight loss. Also during the first few weeks after surgery, your body is in a heal mode.

Antibiotics are among the most frequently prescribed medications in modern medicine. Antibiotics cure disease by killing or injuring bacteria. After surgery antibiotics may be used to preclude wound infection. But there is a downside to the use of antibiotics. Antibiotics kill not only the harmful bacteria but also the helpful or good bacteria in the digestive system that keep our gut healthy. Probiotics are live bacteria and yeasts that restore these lost good bacteria into our digestive system (in the intestines). Commonly probiotics are recommended after gastric bypass and gastric sleeve surgery to restore our gut bacteria. When I went to store searching for probiotics, I saw a wide range of different types (and different prices). They vary by the number of friendly bacteria strains and by the number of colony forming units (CFU's). Also they vary by type of bacterial strains. Generally, Lactobacilli probiotics are most prevalent in the small intestine and Bifidobacteria probiotics are most prevalent in the large intestine (or colon). I came across an interesting article today titled "Can some probiotics have an antibiotic effect?" at http://www.foxnews.com/health/2015/09/03/can-some-probiotics-have-antibiotic-effect/?intcmp=hphz01 So I thought I would share it.

After surgery and during the hospital stage, many people gain weight because they fill your body with fluids. Therefore when you finally arrive home, you will need to lose that weight first before you see any weight loss. Also during the first few weeks after surgery, your body is in a heal mode. It is common for individuals to not lose consistently during this early period. So just relax and let the magic happen.

After RNY surgery, your stomach is no longer able to process foods with high content of fats or sugars (because this part of your stomach has been cut away). Eating this food will cause dumping syndrome. This takes the form of diarrhea. After about a year, your intestines will change and they will begin processing fats and sugars in place of the stomach. So this intolerance will go away. If you each too much volume of food, your stomach will signal very painfully that you have reached your limit. You may vomit the entire meal over the course of an hour or painfully wait it out for several hours. This appears more common with harder foods such as steak, then with softer foods such as Soups and chili.

Right after surgery, the surgeon generally restricts the use of many types of supplements and over the counter medicines. As time progresses, many of these restrictions are lifted. Have you checked with the surgeon's office to see if at 7 weeks post-op if they would let you use Ibuprofen? Is your back pain your only symptom? Did you have a history of back pain prior to surgery? At least one of the complications from surgery has a symptom of back pain.

I am 28 months post-op from RNY surgery. I lost 115 pounds and am maintaining that weight loss. I documented my approach in a short article at http://www.breadandbutterscience.com/Surgery2.pdf

Most people at Thanksgiving table will be more focused on their plate of food than yours. Sit at the table and enjoy the conversation. Drink a Protein shake and just inform them if they ask that your diet restricts you from eating this year.

At the stage you are currently in for meal volume, you have the option to consume a larger portion of Protein through your meals (that is if you are consuming high protein meals). This allows you to reduce your reliance on protein supplements (Protein shakes, protein bars) and the calories that these protein supplements contain. I experienced a plateau at around 3 months post-op. I looked at my calorie consumption and decided my plateau was due to increased calorie consumption, so I dropped from 3 protein shakes a day down to 2 and my weight loss picked up again. As time went on and my meal volume increased, I was able to further reduce my protein shakes down to 1 per day and then none. Because at that point I was consuming all the protein that I needed from my meals.

It sounds like you are experiencing dumping syndrome. Generally those that have RNY surgery go through several phases for meals. During the first 4 weeks post-op: full liquids During the next 4 weeks: pureed foods After week 9 post-op: solid foods. It sounds like you jumped from full liquids to solids after the first 12 days. It sounds way too soon assuming you had RNY gastric bypass surgery. Pureed foods are necessary following surgery to allow the staple lines in your stomach to heal and to prevent nausea and vomiting. Generally to puree food it needs to be blended in a blender. It should have the consistency of pudding.

It can be hard to eat (and drink) after surgery. This should get better as your body heals. Remember to chew, chew, chew when you get into the solid stage. I found that softer foods (Soups and chili) went down smother than harder food such as steaks. One of the men in our bariatric surgery support group meetings had a lapland revision to a RNY gastric bypass because his band was eating into his stomach and had to be removed. Because of the scar tissue that had built up, his new pouch was a little smaller than most RNY patients. Therefore it was a little difficult for him at the beginning with the volume of food per meal. But he turned out well.

Congratulations on your decision to undergo Gastric Bypass surgery. This is a link to my story. http://www.breadandbutterscience.com/Surgery.pdf I hope you will find it useful. Make sure you take a good before photograph so you can compare it with an after photo.

Your taste buds may change after surgery. Therefore you may want to wait until after the surgery to stock up. Also the amount of food you will consume will be so miniscule, that it doesn't make a lot of sense to worry about food. After surgery I recommend that you sample the many types of Protein shakes available and select one that you can tolerate. At this stage there are two important things to do. 1. Walk, walk, walk (around 30 minutes per day). It will help the recovery process go smoother. 2. If you haven't already cut out consuming caffeine. Do so now. When I went cold turkey on my 6 diet Coke a day habit, I suffered withdrawal syndrome (severe head aches and body aches) for about a week. It is best not to compound the side effects of removing caffeine from you diet with the effects of surgery. Better to get over with it now.

I am not familiar with POSE. Apparently this form of surgery is performed in the United States. A quick look-up provides the following information. The POSE Procedure (Primary Obesity Surgery Endolumenal) is one the most advanced incisionless surgical weight loss procedures available to patients today. POSE can be used for patients who have lower BMI and are seeking more conservative weight loss results, making it an attractive alternative to more invasive weight loss surgeries like the Lap Band and Sleeve Gastrectomy procedures. No incisions, no scarring, no bandages and nobody will know you underwent weight loss surgery. POSE weight loss surgery involves reducing the size of the stomach through an endoscopic method that requires no external incisions. The entire procedure is performed through the patient’s mouth. Stomach reduction, as with other weight loss surgeries, helps diminish the patient’s feelings of hunger and reduces caloric consumption. Wish I could be of more help.

I was required to give up carbonated beverages and caffeine prior to surgery. So at the beginning of the process I went cold turkey on my 6 diet Coke a day habit. On that change alone, I lost 20 pounds. But I suffered a week of withdrawal syndrome due to the caffeine. So it was better to go through that well ahead of time than just before surgery so as not to compound the problems. I would suggest walking 30 minutes per day for exercise. It will make your recovery process go more smoothly.

Weight loss in the "Weight Loss" phase is due to portion control. Just consume the amount of food per meal as prescribed by your surgeon. At 7 days post-op, this is probably 2 ounces (1/4 cup). Don't be too concerned about detecting when you are full. Firstly because your body is in a healing mode right after surgery and that is the most important element. Secondly, I suspect you will begin to detect the full feeling once you transition into the solid food stage. The most important requirements after surgery are Protein, fluids and Vitamins. Food is secondary. This is because your body is converting stored fat into the energy that drives your body. Thus you lose weight. Over time meals will become important again. As you progress, you can pack more protein into your meal volume and then start to offload your reliance on protein supplements (such as protein shakes).

Your taste buds may change after surgery. Therefore I might be too soon to experiment and downselect a Protein shake. It might be better to wait until after surgery to perform the experimentation. I had RNY surgery and experimented prior to surgery. After surgery I could no longer tolerate the type I selected initially. I do not know if your type of surgery also had the same effect. You might ask if this trait was common among sleeve patients.

CAN I FORCE MYSELF TO THROW UP TO FEEL BETTER?! Sometimes when I have dumping syndrome, I lean over the sink or stool and try and throw up. If I do throw up, I feel better afterwards. Also it is better when you have dumping syndrome to be in a vertical position rather than in a horizontal position. By that I mean that if you try and lay down, you will generally only feel worse. You may have to sit up and watch TV for a couple hours before the pain settles down.

It is important for you to get your protein in but during the first few weeks after surgery, your body is in a healing mode and many people struggle. So just keep trying and things should get better.

Some people experience a change in the way things taste after surgery. Others seem to experience a change in the way things smell. Chewing is a natural part of the digestive process. Many people report a strong desire to chew something solid especially while they are restricted to the liquid or blended stages.