James Marusek

I am 26 months post-op from RNY gastric bypass surgery. I lost 115 pounds and kept it off. Almost all of my medical conditions (diabetes, high blood pressure, sleep apnea, GERD, frequent urination) have gone in remission and stayed there. Frankly the surgery was one of the best moves I ever made in my life.

I believe the best day for surgery is Monday through Thursday. I had surgery on Friday, so my recovery was over the weekend. The normal weekly hospital staff was not there during the weekend. I had a substitute surgeon generate the discharge paperwork. The whole process seemed slower. I could have been out of the hospital a half a day sooner in my opinion if it wasn't over the weekend.

The Bariatric Discharge Instructions that I received stated: Gastric Sleeve patients take 500 to 1000 micrograms sublingual B12 weekly. Roux-En-Y (RNY) & Vertical Banded Gastric Bypass patients take 500 to 1000 micrograms sublingual B12 daily. Duodenal Switch patients take 1000 micrograms B12 weekly. The RNY surgery rerouted my stomach so that it is no longer capable of synthesizing many Vitamins from foods. Whereas the other surgeries, the patients still retain stomachs that are capable of this function. Sublingual B12 passes into your bloodstream quickly and it is used up quickly. If you took your sublingual B12 within a couple days of when the bloodwork was drawn, that might indicate normal levels of B12 still within your system. Anyways it doesn't take a rocket scientist to figure this one out. Try taking 500-1000 micrograms of sublingual B12 daily for a week and see if it improves your energy levels.

I had RNY surgery, and the recommended Vitamin regiment was 500-1000 micrograms sublingual B12 daily. If you are taking the sublingual weekly, you might be deficient. A B12 deficiency could cause pernicious anemia, mood swings, paranoia, irritability, confusion, dementia, hallucinations, or mania, eventually appetite loss, dizziness, weakness, shortness of breath, heart palpitations, diarrhea and tingling sensation in the extremities. B12 deficiency has also contributed to anxiety, stress, and depression. A B12 deficiency could explain the weakness you are experiencing.

What type of meds are you taking. If you had high blood pressure before surgery and took meds for it and are still taking BP meds after surgery, it might drop your blood pressure too low and make you lethargic.

Part of the psych evaluation is to determine if you have the will to follow the program. The day I decided I wanted the surgery, I went cold turkey on Cokes. I had a 6 Coke a day habit and I knew the program wouldn't allow that. When I met with the psychologist, I told him what I did. He was pleased. The fact that you have begun exercising is a plus. It is a positive step in the right direction. Keep it up.

If you want the results then you need to stay with the program. I prepared my own meals and generally ate alone. The program is pretty rigorous and hard to stay on track, but it is worth the effort.

Several years ago, I suffered several occurrence of what appeared to be gout. One foot swelled and was very painful. The condition would last for a couple days and then disappear. I spoke to my doctor and he said that generally there isn't a good blood test to detect the condition. The best way is to take one tablet of gout prescription medicine and if the problem disappears swiftly, then it is gout. Well I purchase one tablet, but the condition was so infrequent that I never used it. I did find that putting a heat pad on the affected area seemed to really help in relieving the pain and making the problem go away.

It is somewhat common for individuals that have gastric bypass bariatric surgery to experience hypoglycemia even if they were not diabetic prior to surgery. Most people can detect when an episode is coming on and take something to snap them out of it before their blood sugar gets too low. This condition can be treated by consuming: 1/2 of fruit juice 1 cup of skim milk 1 tablespoon honey (put it under your tongue so it gets absorbed into your bloodstream faster) 2 tablespoons of raisens, or glucose tablets

Your use of artificial sweeteners will be fine (even preferred) after WLS.

How are you doing on your Protein, Fluid and Vitamin requirements? During the losing phase, food consumption is not as important. It almost sounds like you are exceeding the maximum volume requirements for the meals at your stage in the program. I only knew of one person who went from lap band revision to RNY. He had to have it done. His band was eroding into his stomach. As a result when they did the revision, they made his pouch smaller than the average RNY. He could eat as much as most RNY patients. But he lost a lot of weight and was pleased with the result of his revision.

Good luck on your upcoming weight loss surgery. I had diabetes and high blood pressure before my gastric bypass operation. They went into remission almost immediately after surgery and have remains so to date (26 months post-op).

Many individuals that have gastric bypass surgery mention that sometime they experience hunger. Many times people describe this as head hunger, which is like a pseudo hunger, it is a strong desire to eat certain foods. Most times this occurs early when we are still in the liquid or semi-liquid phase. When we eat foods, chewing is important. The act of chewing release chemicals in the body that aid the digestive process. So many individuals report a strong desire to eat food that involve chewing.

That doesn't sound very normal at 21 days out. Perhaps there is a kink in the plumbing. In some cases, scar tissue or inflammation can narrow the new connection between the stomach and intestine. This is called a stricture. Strictures usually develop four to six weeks after surgery, and affect less than five percent of bariatric surgery patients. Patients with strictures will notice that they are progressively less able to take in fluids and food. Strictures can be treated with an endoscope, which is a thin, flexible tube with image sensors and special tools at the tip. A doctor will use an endoscope with a tiny inflatable balloon at its tip to open the stricture.

I had a RNY gastric bypass about 26 months ago. I was in the hospital for 2 days and then returned home. While I was in the hospital, I was up and about every 2 hours walking. I needed someone to drive me home but once home I didn't need any help getting around. So in general, I think the answer is no. But I did not use any pain medicine after I left the recovery room. If you are on pain medicine, it might affect your balance. Also some people in the hospital found it very difficult to get up and walk. So I guess it depends on the person and your particular medical conditions.

I do not think they will let you drive home from the hospital. It is a little too soon. You will need someone to drive you home.

I went through the same stall. But at 3 months, I was consuming larger meal portions and thus more calories. I modified my eating habits to consume more Protein in my meals which allowed me to reduce down the amount of Protein shakes (and their calories) which I consumed each day. And the weight loss again picked up.

I have a sweet tooth and that is one of the reasons why I gained weight over the years before my surgery. As time went on I became diabetic and that can lead to a whole slew of problems. Fortunately today there is a wide range of options that I can use to control my craving. I am 26 months post op from RNY surgery and I am stable weight-wise in a maintenance mode. I am at the bottom end of the scale. Sugar is a very complex issue, so let me describe the rules that I currently follow. My diabetes went into remission the day I left the hospital and has remains so over these past 26 months and I periodically check my blood sugar levels to validate the approach that I use. I strictly avoid processed sugar in its many forms. That includes most foods ending in (-ose). That includes sucrose (table sugar), fructose (honey), dextrose (glucose), corn syrup, corn solids, high fructose corn syrup, cane juice. I look at food labels on the products I buy. I first check the % sugar under the total carbs. If it lists more than 5 grams of sugar, then I look at the ingredients portion of the label. If one of these sugars is among the first 5 ingredients listed, I generally avoid the food. [The manufacturers are required to list the ingredients by the percentage within the product, so the first item listed is the highest percentage of the food in the product, and the second item listed is next in percentage. That is why I focus on the first five ingredients.] This approach is a holdover from the surgery. After my RNY surgery, the part of my stomach that processed sugars and fats was cut away. If I ate either sugar or fats in high levels, it would immediately cause a bad reaction by my body rejecting it. This is called dumping syndrome. After about the first year, my body evolved and my intestines now begin to perform the functions that my stomach once performed. Therefore, I can eat sugars and fats and absorb it. I use the following types of sugars: natural sugars (found in fruits and milk), artificial sweeteners (such as Splenda), very low calorie natural sweeteners (such as stevia, and sugar alcohols). These products offer me a wide range of options to control my sweet tooth. After my first year following surgery, my body can once again process fats and this in my opinion is the key. Fats have the ability to take away hunger and they in my opinion are the key in the maintenance stage. Generally, I will have a cup of coffee in the morning with a large scoop of whip cream. The whip cream is home made and contains no sugar. I use Splenda in its place. Throughout the day, eat a few Adkin's treats. These products are similar to candy bars but contain no processed sugar. They take away the craving because they contain fat and use sugar alcohol as a sweetener. I also consume natural sugars found in fruits in moderation and natural sugars found in milk. I consume whole milk and eat real butter. [This approach is not something you can do right after surgery, you need to wait until your intestines evolve.] As I say, I periodically validate my approach by monitoring my blood sugar levels. I have informed my nutritionist of my approach and they seem to be fully onboard. [sometimes between you and me I think they are a little bit in awe, because my weight levels are still falling 26 months after surgery.]

I went from a size 3XL down to a size Small in shirts and from a size 46 down to a size 32 in pants. So I guess there is a real chance that you could meet this goal.

I trust my nutritionist. They are specialized towards bariatric surgery. When you consider that there are two phases to bariatric weight loss surgery - the losing phase and the maintenance phase. I found their advice spot on when it came to the weight loss phase. But after you reach the maintenance phase, I don't observe a well defined plan in place. My body changes as I transition through the process. In the beginning fats and sugars were rejected because that portion of my stomach was cut away. But after about a year, my intestines have evolved to process fats and sugars. Therefore what might be good advise at the beginning is bad advice later on.

No, but I agree with you that it sounds like a good thing.

Probably just overthinking the whole thing. When they asked me, I didn't know what to say either so I picked a number out of thin air. I met that goal early on and continued to drop almost another 40 pounds below that number.

I have found that if I eat just before I retire for the night, the food sits heavy in my stomach. Sometimes I have to get up and vomit. Then I have to stay awake for several hours until my stomach settles down. As a result I have altered my eating habits to never eat before I retire for the night.

The purpose of Pre-Op testing is to identify any problems or complications that can make you weight loss surgery unsuccessful. Generally you go through a first round and if that detects any anomalies, then you are directed to undergo a second round performed by specialist in those particular fields.

If you have GERD, then you will probably be advised to have gastric bypass (RNY).