James Marusek

My weight loss phase lasted around 7 months and then I leveled off and went into a maintenance phase. I am over 2 years post-op RNY and my weight is stable and very close to my bottom weight. Around half way through my weight loss phase, I plateaued. I looked at my calorie intake including my Protein shakes and thought I could cut back a little. That was because I was gaining more protein from my meals since my meal volume increased. So I went from 3 Protein Shakes a day down to 2. I began to lose weight again. It was midway in my weight loss journey. As time went on I dropped down to 1 Protein shake a day and then none. The protein requirement is the amount of protein derived from meals combined with the amount of protein from supplements (protein shakes and protein bars). If you concentrate on eating high protein meals, it diminishes your need to consume calories and extra protein supplements.

The milder side effects come before full dumping syndrome. They are like an early warning system. Once you begin to recognize the signs, you learn quickly to just stop eating.

I took Citracal (calcium citrate). These are horse tablets. One of the problems that I unexpectedly encountered after surgery was that I was unable to swallow most of my Vitamins. I had to buy a pill splitter and a pill crusher. The Citracal tablets had to be crushed and the powder was very hard to take because it tasted like chalk. I landed up mixing it with Crystal light and drinking it. After a couple months my ability to swallow was restored and this no longer became a problem. There are a variety of options on your calcium requirements. Some I have heard are very enjoyable to take. It must be calcium citrate. So you might experiment at least until your ability to swallow is restored.

That seems like a lot of exercise. At your current weight 287 pounds, that would be equivalent to approximately: 158 minutes of low impact aerobics, or 124 minutes of moderate bicycling, or 145 minutes of cross country hiking, or 145 minutes of vigorous weight lifting. On the other side of the question, I am not too sure what you mean by starvation mode but I will assume you mean at what point the exercise vs. calorie intake might negatively affect your health. It is important to make sure you get enough Protein. In the losing phase it is critical to meet your daily protein, Fluid and Vitamin requirements. Meal intake is less important because your body is converting stored fats into the energy to drive your body (starvation mode). Thus you lose weight. If you fail to intake enough protein during this process, you will experience some signs, such as your hair falling out. It is possible to get so much into exercise that you might adversely affect your health, but the human body is fairly adaptable. I encountered one individual who picked up the bicycle riding enthusiasm after surgery. He competed in a bicycle race across the state of Indiana (160 miles). He crossed the finish line and then collapsed because of a lack of energy. After a little food and drink, he was back on his feet - no harm done.

As your volume increases, the amount of Protein you consume from meals increases. I am up to a cup per meal and derive about 65 grams a day from my meals alone. I went from 3 protein shakes a day, down to 2, down to 1 and then eventually down to none. I eat homemade high protein chili and soups. I have included some of the recipes in the attached link. These have about twice the protein content as store bought chili and soups. http://www.breadandbutterscience.com/Surgery.pdf Also in time you will be able to transition to Protein Bars as a supplement which come in handy when you are on the go.

Physical labor is a good substitute for structured exercise. Last year on my of my projects I moved 100,000 pounds of gravel by hand and 50,000 pounds of landscaping blocks. I just took my time. I have a lot more stamina (the ability to perform physical labor) since my surgery. I have a long driveway (about 800 feet) and during winter because I am in the Midwest, I need to shovel snow. This is also good exercise. Structured exercise seems more like make-work to me. It is in my opinion wasted effort. It seems like it could be better channeled into meaningful tasks.

After surgery everything is in transition. There is the transition from full liquids to pureed foods to solids; the transition in allowed meal volume; and the transition to allowed food categories. Each transition opens up new opportunities. So experiment. In Indiana they have a saying. If you don't like the weather, wait 10 minutes. It is sort of like that with food after surgery. I documented the approach I used after surgery in the following article. I hope it is of help. http://www.breadandbutterscience.com/Surgery.pdf

Good luck on your surgery. I am happy with the results of my RNY surgery 2 years ago.

It is common for people with lap bands to have a revision to RNY gastric bypass surgery. One of the individual in our support group went through this process when his band started to cut into his stomach. After surgery he was very happy with the results.

I had high blood pressure and diabetes prior to surgery and a few other problems. I took meds for these conditions but very quickly after surgery all these conditions went into remission and I am off all my meds except for my asthma meds. I was off the diabetes meds two days after surgery when I left the hospital. I was off all my high blood pressure meds two weeks after surgery. I am 2 years post op from RNY.

I described my experience with WLS in the following article. Hope it will help. http://www.breadandbutterscience.com/Surgery.pdf

I hope you resolve the problem with your shoulder.

I will pray that your surgery goes well and that you are happy with the results in the longterm.

I had RNY surgery and did not experience any hair loss. But some have reported this as a problem. It is important to make sure that you meet the minimum daily Protein requirements especially as you approach your bottom weight because a lack of protein can cause hair loss.

Some people who have RNY experience episodes of low blood sugar "hypoglycemia". The symptoms are: lightheadedness or dizziness blurred/impaired vision rapid heartbeat tingling or numbness in lips or tongue sudden mood changes sudden nervousness confusion unexplained weakness or fatigue pale skin headache hunger shaking sweating, chills and clamminess difficulty sleeping trouble thinking clearly or concentrating loss of consciousness To correct this condition at the onset, take one of the following: a half cup of fruit juice 8 ounces of milk 2 tablespoons of raisins 1 tablespoon of honey 4 or 5 saltine crackers 3 or 4 pieces of hard candy or glucose tablets If you are experiencing this condition, it is important to learn to recognize your symptoms and treat them fast.

I took a before and after photograph. It is really amazing when you put them side by side. http://www.breadandbutterscience.com/Operation.jpg What a difference 6 months makes.

I had RNY gastric bypass surgery 2 years ago and dropped 110 pounds and kept it off. I had several episodes of severe acid reflux (GERD) prior to surgery and RNY is the best approach for this condition.

Keep doing what you are doing. It is common for the scales to stop every now and then. Try and not get fixated on it. You may see your progress in other ways such as dropping a clothing size. It is possible to slow your weight loss by extreme exercise. When I was young, I began jogging. Over a few weeks I was able to build myself up to 10 miles per day. Instead of losing weight, I gained weight because I was replacing fat with muscle and muscle is denser than fat. But that is a good thing.

Water should pass right through your pouch. That is why they tell you not to drink fluids when you consume your meals. (Otherwise your food might also travel through your stomach right into your intestines without first being processed.)

During the first few weeks it can be hard meeting the requirements but then it gets easier with time. Find a Protein shake you can tolerate. I would blend in a half a banana into my Muscle Milk Light (vanilla cream) powder using Water and my Ninja blender and it help to make the protein shake tolerable. The important thing is to experiment. [The banana does not count against your meal allotment.]

Over the years I drank Cokes and later Diet Cokes. One of the requirements after surgery is to cut out all carbonated beverages and caffeine. I decided to implement this change when I entered the medically monitored diet and exercise program in order to qualify for surgery. That change alone caused me to drop 20 pounds. I believe the carbonation was the cause of the weight loss. Carbonation is like producing microscopic explosions in the stomach which causes it to expand. The larger the stomach, the more food you can eat and as a result the more weight one gains. This also turned out to be a good change because I suffered from withdrawal syndrome when I went cold turkey on a 6 coke a day habit. So it is important to flush your body from caffeine early because you don't want to go through these withdrawal syndrome combining it with the effects of the operation. The other thing I did pre-op was to become more conscientious about my calorie intake. I looked at the calories of everything I ate and changed my diet. I no longer ate ice cream or milk shakes. No more pizza. But Taco Bell tacos were O.K.

Some people who had RNY surgery suffer from low blood sugar after surgery. I don't know if duodenal switch patient also are affected by this condition. One of the symptoms of low blood sugar is irratability and personality changes. If this condition becomes severe, you may find yourself fainting. So if you begin to show other symptoms, you might look into this.

Sounds like you are the 6 week mark. In the early stages meeting the Protein, Vitamin and Fluid requirements are critical. food is secondary. Your body is converting stored fat into the energy that drives your body. That is why you are losing weight. I found that eating soft foods such as chili and Soups went down much easier than hard foods such as meats, etc. So I went with that. (The liquid portion of soups count towards meeting your fluid requirement but not your meal volume limits.) It is important to experiment and find things that you like to eat.

A year ago, I had a stomach flu. It lasted for 7 days and then it was gone. I had no appetite and couldn't keep anything down. I wondered if you might have the same condition.

Past thread indicate that this problem has occurred in others. It is not common. The causes discussed were: * Reaction to pain medicines * B12 deficiency * New allergic reactions to foods. Since you body has been surgically changed, you may be experiencing an allergic reaction to some foods that you did not experience prior to surgery. * Increase in bile salt in the gall bladder