James Marusek

The rate at which one loses weight following surgery is dependent on the type of surgery. A weight loss of 60 pounds over 4 months isn't bad. You just need to sustain it. You are beginning at a high initial weight and you need to control the depth of the weight loss. The most important elements during the weight loss phase is meeting the requirements of Protein, fluids and Vitamins. food is secondary because your body is converting stored fat into the energy that drives your body. If you had RNY surgery and your food allotment has increased, then I would like you to look at your caloric intake. You should include in your total calories the calories from your meals combined with the calories obtained from your protein supplements. If you are consuming high protein meals, then at 4 months your food allotment has increased to the point that you could reduce the number of Protein shakes you are consuming each day and thereby also the amount of calories you are consuming from the protein shakes. That is what I did and my weight loss increased.

I stopped losing weight at 7 months post-op and I went from a "Weight Loss" phase to a "Maintenance" phase. I am now 27 months post-op RNY. Since that time I have dropped another 15 pounds without really trying and I am currently near the bottom end of the scale. I attribute this added weight loss to the following: 1) A couple times I developed a stomach flu that was going around. I would lose my appetite for a few days and drop weight quickly. After I recovered, I would decide this was my new goal weight and not try and gain it back. 2) I have found that softer foods such as chili and Soups go down easier so I primarily rely on these for my meals. Whenever I eat out, I find that I cannot consume very much harder foods and as a result I lose weight. 3) I believe the meal plan for those in the Maintenance phase should be very different than in the Weight Loss phase. After surgery, the stomach that normally absorbs fats and sugars has been cut away. That is why your diet needs to restrict fats and sugars; otherwise it leads to dumping. But after about a year, you intestines change and the intestines begin to convert fats and sugars. So in the Maintenance phase the objective is to "not be hungry". Fats take away hunger. So I reintroduced fats back into my diet. And for the most part, 27 months post-op, I am never hungry. On the other hand, I almost religiously restrict myself from processed sugars. I read food labels; I really read them. If they contain more than a couple grams of sugar, I look at the ingredients to determine if they contain high amounts of processed sugars. For my sweet tooth, I consume artificial sweeteners (such as Splenda, sugar alcohol), natural low or no calorie sweeteners (such as Stevia), and natural sugars found in fruits and milk. So in general, I consume a cup or two of hot coffee each day with a very large scoop of whip cream. The whip cream I make myself using heavy whipping cream and Splenda in place of sugar. This adds fat into my diet. I also consume 2 or 3 Adkin's treats per day. I also use whole milk, real butter and real meats. I restrict my meals to one meal per day with complex carbs (such as Pasta, bread). In the maintenance phase, the meal plan should include a balance of Protein, fats and carbs. Fats are an important ingredient.

First, let me explain that I have no experience with bands, so whatever I say take with a grain of salt. This problem may not be GERD related. If it continues you might want to seek the professional help from your doctor. You indicated that your band is currently empty because of some erosion. There was one individual in our bariatric support group meeting that went from a band to a RNY revision because his band was eroding though his stomach. The band had to be removed. The erosion was very serious.

Hiccups are one of the signs that a person has eaten to much and should stop before they begin dumping. But since you had surgery yesterday (probably still in the hospital with very little food), I think this is too soon for you to encounter this symptom.

A recent study compares the effectiveness of two types of bariatric surgery — laparoscopic adjustable gastric banding vs laparoscopic gastric bypass. The investigators concluded that the bypass surgery, although having a greater risk of short-term complications and long-term hospitalizations, also resulted in much greater weight loss as well as a lower risk of subsequent interventions. http://acsh.org/2014/11/study-compares-effectiveness-two-types-bariatric-surgery/

Because I have been snoring so loud for 2 or 3 years before surgery that my wife constantly complained that she lost a lot of sleep. As a result as part of the pre-op RNY testing, I was directed to make an appointment to see a pulmonologist. I set up an appointment and met with him. He said there was a good chance I had sleep apnea and wanted me to do a sleep test. I told him that I didn't want to do a sleep test because my RNY will probably correct the problem. I told him that if I still snore after the surgery I will set up an appointment and undergo a sleep test. He agreed. Within 2 weeks after surgery I stopped snoring. I would find my wife hovering over me in the middle of the night, listening if I was still breathing because I was so quiet it was scaring her.

Some Protein shakes contain lactose and others do not. Make sure the Protein Shakes you are using are identified as "lactose free". I used Muscle Milk Light and it was lactose free. I had the same problem. Luckily the lactose intolerance went away after a couple months. As far as meats, I found that consuming meats in chili and Soups went down easier than meat as a separate meal element. I wrote a short article of my experience. It includes some recipes. http://www.breadandbutterscience.com/Surgery.pdf

Hypothyroidism is a condition in which the body lacks sufficient thyroid hormone. Since the main purpose of thyroid hormone is to "run the body's metabolism," it is understandable that people with this condition will have symptoms associated with a slow metabolism. The estimates vary, but approximately 10 million Americans have this common medical condition. In fact, as many as 10% of women may have some degree of thyroid hormone deficiency. One of the symptoms of hypothyroidism in weight gain or increased difficulty in losing weight. Because the body is expecting a certain amount of thyroid hormone the pituitary will make additional thyroid stimulating hormone (TSH) in an attempt to entice the thyroid to produce more hormone. This constant bombardment with high levels of TSH may cause the thyroid gland to become enlarged and form a goiter (enlarged thyroid). Left untreated, the symptoms of hypothyroidism will usually progress. Rarely, complications can result in severe life-threatening depression, heart failure, or coma. Goiters and some other thyroid conditions can be treated with radioactive iodine therapy. The aim of the radioactive iodine therapy (for benign conditions) is to kill a portion of the thyroid to prevent goiters from growing larger or producing too much hormone; I feel that rather than focusing on the weight gain, the better focus should be correcting the enlarged thyroid. I recommend you discuss this issue with your doctor.

Good luck on your surgery.

After I lost weight, I noticed that overnight very fine wrinkles covered my whole face. I'm old (66) but I looked like I was 100 years old. I was disappointed with the effect of the surgery on my face. My wife suggested using a moisturizer called BioOil which I purchased at CVS. I bought it and used it and began looking young again. You have dropped almost half your former weight. Probably need to let your body catch up.

I didn't notice any reduction in shoe size or shoe width after surgery. But others including males in our bariatric surgery support group meetings did.

Many people have a hard time reintroducing meat back into their meals after RNY surgery. The meat seems too tough for their stomachs. As for chicken, the best approach for tenderizing the meat is to put a chicken breast in a covered pot with Water and a couple bouillion cubes. Cook it for a couple hours until the chicken readily comes apart using a fork. For most meats, I found that if you use them in Soups and chilis they go down smooth. It is important to use very lean fat free meats after surgery because your stomach cannot absorb fats and sugars after the operation. After the first 6 months to a year post-op, your intestines adapt to absorbing fats and sugars taking over a function that was once the stomachs. At this point meat that contain fat is tolerated without causing dumping.

Around 4 months post-op when seafood (crab legs, shrimp, lobster) finally showed up on my allowed list, I tried some crab legs. Was I disappointed. It completely lost its flavor. At 9 weeks you have all the ingredients to make chili (hamburger, tomatoes, kidney Beans, tomato soup). I found that what brought flavor back into foods was mixing food groups together. At 6 weeks, canned tuna is on the list. I found that to be good. I don't think salt is excluded from the diet. I used seasoning from the get-go. (But it might be awhile before you can eat salty Snacks (pretzels, chips, nuts etc.))

Good luck on your surgery. I will pray for both of you. Check back in when you are on the other side.

I put my experience with gastric bypass surgery in a short article. http://www.breadandbutterscience.com/Surgery.pdf

After RNY surgery, I became lactose intolerant. A couple months later that problem disappeared and I could once again drink milk. The most important detriment to lactose intolerance lies in Protein shakes. Some contain lactose but fortunately many do not. It is important to select Protein Shakes that are lactose free.

Maybe it was God's plan for you to have the sleeve.

I didn't have a drain so I didn't go through that. Things will get better with time. It took about 6 months to reach my happy state. Shortly after surgery, food is relatively unimportant. This is because you body is converting stored fat into the energy that runs your body. As a result your body loses weight. The important elements are Protein, Vitamins and fluids. In the beginning you need to be on Protein shakes. I was taking 3 protein shakes a day in the beginning. As I obtained more protein from foods as my meal volume allotment increased, I reduced this to 2 shakes a day, then 1 shakes a day and finally none (when my volume was at 1 cup per meal).

Your body has a natural need to chew. It is an important part of the digestive process. http://articles.mercola.com/sites/articles/archive/2013/07/31/chewing-foods.aspx By solely eating liquids you deprive your body of this need. Luckily this phase does not last long and you will soon transition into solids.

In the beginning the complexity of the requirements can easily overwhelm you. Vitamins have to be spread out throughout the day. You can no longer swallow medium to large vitamins and have to break them up. Getting in the fluids and the Protein shakes that taste awful. Giving myself the daily blood thinner shots in the stomach wasn't fun. My love of food came to an abrupt end. I lost the enjoyment of eating. Luckily things get significantly easier with time. Having said all this, having RNY gastric bypass surgery was one of the best decisions I every made in my life.

I sleep on my side. But after surgery this was uncomfortable. I found it important to place a pillow between my legs when I sleep on my side after surgery.

Immediately after surgery, the most important requirements are Vitamins, fluids and Protein. Your meal allotment is less important and microscopically small. Your body will get its energy from converting your stored fat. Thus you lose weigh!. So even though you may struggle with foods, you have to get the vitamins, fluids and protein right. Another problem you may encounter is that your taste buds may change. Foods that you might enjoy before surgery may have no flavor after surgery. So too much preplanning may be a wasted effort. Be open to experimentation after the operation. As my meal allotment increased after surgery and my list of acceptable foods increased, I found that high protein chili and Soups went down the easiest. I have included a few recipes in the attached article. http://www.breadandbutterscience.com/Surgery.pdf It's a good idea to take a before picture. If you are like me, you do not really look in a mirror at yourself. Truly look. So when we lose the weight we tend not to see the change. If you take your own photo and retake it after you lose the weight, replicating the exact same pose, it will show what you have accomplished. Here is mine. That will give you an idea of the value of these photographs. http://www.breadandbutterscience.com/Operation.jpg

It took me about 6 months to reach a happy state when all the problems were resolved.

Congratulations and best of luck on your surgery. I will pray for your surgery and recovery. Check back in later and let us know how it went. Congratulations and best of luck on your surgery. I will pray for your surgery and recovery. Check back in later and let us know how it went.

I have found that many people are really curious about weight loss surgery. Some are struggling with obesity, others know someone else who is. They want to find out what actually works and how. I had several people come up to me and congratulate me on my weight loss. I found this to be very strange because unlike a diet, I feel I am only along for the ride. I think our society believes in positive reinforcement for achievements through dieting. But this is not dieting. I guess the point of my rambling is that some people are only curious and mean no ill harm. They believe they are giving you positive reinforcement.