James Marusek

One of the outcomes of RNY surgery is that some patients experience hypoglycemia (low blood sugar) after surgery. This even affects individual who are not diabetic prior to the operation. I was diabetic prior to the operation and it went into remission by the time I left the hospital. I avoid sugar and several other sweeteners. But I have a sweet tooth and use a variety of other sweeteners. The sugar in milk and fruits are natural sugars that do not affect my blood sugar levels. There are many different types of sugars. Some are bad and some are O.K. Because I underwent training in preparation for my Weight Loss Surgery, I have a better understanding of the difference. So if you are diabetic, it is important to know the difference. The sugars to avoid are: sucrose (table sugar), fructose (honey), Dextrose (glucose), Maltose (malt sugar), Xylose, Corn Syrup, Corn Solids, High Fructose Corn Syrup (HFCS), Cane juice, Molasses, Caramel, Corn Sweeteners, Evaporated Cane, Brown Sugar, Barley Malt, and Beet Sugar. I think a few more types of sugar also fall in this category but I don't know for sure. These are Agave, Pure Maple Sugar and Date Sugar. Sugar is integrated into so much of our food today, its hard to know what is an acceptable level. Generally if one of these sugars are listed in the first five ingredients on the food label of a product it should be avoided. Take for example Campbell's Tomato Soup - It contains 12 grams of sugar and the second ingredient on the food label is High Fructose Corn Syrup. So even innocent items can become a problem. I try to limit my intake to no more than 2 grams sugar for a product. So generally I don't eat Campbell's tomato soup anymore but I do use it when I make chili because it is cut to a minor portion. On the other side is sweeteners that a diabetic can probably consume safely. They include artificial sweeteners and some natural sweeteners. Generally the artificial sweeteners have zero calories, so they are easy to spot. These sweeteners include Acesulfame Potassium (Sunett and Sweet One), Aspartame (Equal, Nutrasweet), Neotame, Rebiana (Truvia, Pure Via), Saccharin (Sweet N' Low), Sucralose (Splenda) and then natural sweeteners such as Stevia, Monk Fruit, whey Low, Coconut Sugar and Sugar Alcohol (Sorbitol, Xylitol, Mannitol, Erythritol). Many of these acceptable sweeteners are beginning to show up in more and more products in the grocery counter. In many cases if the product is listed as No Sugar Added it might be acceptable. But you need to analyze the food labeling. For example Nesquick makes a No Sugar Added Cocoa. It uses Sucralose (Splenda) as a sweetener. No sugar added ice creams are starting to show up in the store. Some brands of ice cream are using Aspartame (Nutrasweet) and Glycerine (sugar alcohol) as sweeteners. Another product it candy. Adkins makes a variety of candies that use sugar alcohol as their sweeteners. There are two other types of natural sugars that are O.K. These are the natural sugars found in fruits and milks. But some products are deceptive. You may have to read the food ingredient label because for example some fruit juice adds sugar to the juice and the product is primarily sugar.

I maintain a running log of my daily weight. Here is my before surgery photo and 6 months post-op photo. http://www.breadandbutterscience.com/Operation.jpg Here is a short article of my experience. http://www.breadandbutterscience.com/Surgery.pdf />

Welcome to the site. I imagine you have some interesting questions. Let us know and we will try and help.

Welcome to the site. I imagine you have some interesting questions. Let us know and we will try and help.

I had RNY surgery 20 months ago. Within 2 weeks after surgery many of my medical conditions went into remission and have remained there. They include high blood pressure, diabetes, sleep apnea, severe heartburn attacks (GERD), frequent urination, and excessive sweating. The weight seemed to roll off after surgery. I lost 20 pounds pre-op and another 90 post-op. And more importantly I have been able to maintain the weight loss. After surgery, I found it difficult to swallow large pills. I used a pill crusher and a pill splitter. After around 2 months, I was again able to swallow large pills. In RNY surgery, they cut your stomach in two parts. The smaller of these two parts is now your new stomach. This new stomach is unable to convert food into Vitamins like your old stomach so therefore an individual who undergoes RNY must take daily vitamins. It is a requirement. Since I have been taking vitamins almost my entire life, I do not view it as a problem. I am still taking vitamins just a lot more of them. I have yearly blood work done to make sure my Vitamin levels are adequate. Side effects? There is a lot of hassle in getting in the required Protein, fluids, vitamins, exercise in the beginning. But over time it becomes much, much simpler. It took me 6 months to reach my happy state. I would do the operation over again in a heartbeat.

Yes, that is one of the hazards of stocking up before surgery. Your taste buds change. After surgery I also thought chocolate protein shakes did not taste good. As my meal plan progressed I was eventually able to get most of my protein requirement from meals and no longer drink protein shakes. But I do drink during the winter a warm glass of cocoa (no sugar added). And it's very enjoyable.

There was very little pain for me. The nurse who administers pain medicine would come in every now and then and ask me my pain level. I told her 1 on a scale of 1 to 10. She would leave very upset. After surgery I walked every 2 hours. The nurse came to me after a while and said that I should reduce the number of laps that I was walking. Walking really helps with the recovery.

I ran into a severe problem with constipation. What cured it was eating an apple just before bedtime. But I had to eat the skin of the apple. I have been constipation free for over a year now. Others found that using an herbal tea called "Smooth Move" helped. Whatever you do make sure you are drinking the required amount of liquids each day. Constipation is a sign of not drinking enough liquids.

Most bariatric surgery today is done as minimally invasive. As a result there is less pain and quicker recovery. In my case, I specifically asked for no pain medicine after I left the recovery room and I had very little pain while in the hospital. (I may be the exception to the rule.) I believe the reason for the low pain was that I consistently walked before and after surgery. Walking really helps. I spent two days in the hospital and went home. I am 20 months post-op from RNY surgery and do not regret my decision.

Weight loss rates are dependent on the type of surgery. I had a RNY and experienced rapid rate loss. At the end of 6 months, I bottomed out and have been in maintenance mode for over a year. Those that are sleeved lose weight slower but the weight loss is extended over a longer time. They can achieve the same or even deeper weight loss but over a longer period of time. Don't get discouraged but just keep on truckin'.

It is common to loose a lot of weight quickly after weight loss surgery and then level off and slide into a stall. It happened to me. I looked at my caloric intake counting my meals and Protein shakes and then I trimmed off a hundred calories, then I started loosing weight again. As far as gout, I may or may not have gout. It would flare up in my feet with extreme pain every now and then. I never had it medically diagnosed. The symptoms occurred prior to surgery and after surgery. But it has been about a year since the last episode. I usually find relief by using a heat pad on my foot for several hours.

A recent European study found that a brisk walk for about 20 minutes per day by inactive individuals could reduce the risk of death significantly. The authors noted that of the approximately 9 million deaths in Europeans in 2008, based on the current study, 337,000 may have been linked to obesity, but twice that number may have been attributed to physical inactivity. http://acsh.org/2015/01/just-little-walking-confers-health-benefits/

A before and after picture is worth a thousand words. For me, one of the main benefits of surgery was that most of my medical conditions such as high blood pressure, diabetes, sleep apnea, profuse sweating, frequent urination and GERD went into remission. I do not know if you had any medical conditions going into the surgery, but if you did, that might be a talking point. Another area might be non-scale victories. After loosing weight, I was dropping clothing sizes almost every two weeks until I stabilized. I didn't expect the joy I found in going to the store and buying new up-to-date fashions. Many times I hear people talking about gaining energy after weight loss surgery. I don't think that word describes the change. For me it was gaining stamina. This summer I worked on one of my projects at home and I moved 100,000 pounds of gravel and 50,000 pound of concrete landscaping blocks. I am 66 years old and I found that I could do things like I was 35. A dramatic increase in stamina. But that's me. What were your non-scale victories. The best of luck to you in representing the weight loss surgery community.

I am 20 months post-op from a RNY surgery. After 7 months I lost the weight and entered a maintenance phase. My weight has been steady thus far. I asked my nutritionist "Why do people lose the weight after surgery and gain some of it back when they reach the maintenance phase?" She said it is because of grazing. She said if I continue doing what I have been doing, the weight should stay off. In the weight loss phase, my caloric intake was very small, under 900 calories per meal. But when I went into the maintenance phase, I found there was a range (around 1000 to 1500 calories), that if I stayed within this range, I didn't gain weight. I get most of my Protein from my meals now, so I do not need protein supplement, nor the calories associated with them. So I have around 500 calories per day to play with which I put in the snack category. From past experience, I know that fats work for me in eliminating hunger. So generally that is what I focus on for Snacks. I might have a scoop of home made (no sugar added) whip cream made with Splenda with a cup of coffee in the afternoon. Or I might eat some Adkin's snacks or treats. I try and stay away from carbs when I snack. I avoid sugar with a passion even though I have a sweet tooth. I opt for artificial sweeteners or some low calorie natural sweeteners. Prior to surgery I was diabetic. This went into remission the day I left the hospital and has stayed in remission ever since. I periodically monitor my blood sugar levels to make sure my meal plan is avoiding that condition. Anyways, that's what I do. Although the program provided a lot of guidance during the weight loss phase, I feel like I am on my own in the maintenance phase. But I think the key is discovering a meal plan that keeps one happy without gaining weight.

Unlike others, I was never really into dieting. I tried two diets in my life. The first was a low fat diet. That was a total disaster. I was climbing the walls with hunger. I didn't loose weight and my blood pressure went through the roof. Later I tried a low carb diet. That one worked but after a while it was hard to stay on it. There is a lot of effort when one tries to lose weight and diet. Undergoing bariatric surgery has a lot of effort but it is dealing with the complexity of meeting the meal, liquid, Vitamin, Protein requirements. Hunger is not constantly gnawing at your bones. So in a way it is effortlessly - it just happens.

I told everyone even strangers on the street. Most people were either supportive or curious about the operation. After I lost the weight, many people were confused. They equated weight loss surgery with dieting. They would ask how much weight I lost and then they would congratulate me for all my effort. It tried to explain that it was the surgery that produced the weight loss and I was only along for the ride. But they never really understood.

Hill walking is a lot different that walking on a level surface. It uses different sets of muscles. One set when you are going uphill and another set when you are going down. It might take a week or two to build up your stamina but it is a good workout. I walk up and down my driveway which is on a hill. When I walk on a flat area such as a mall, I find that it seems like I am actually floating.

I based my decision on revision rate. I decided that if I had to undergo surgery, I only wanted to do it once. Not repeat it with a revision on a revision on another revision.

Generally scattered around the country there are bariatric surgery support groups that meet once per month. These meeting are free. They are a way for you to meet others that are undergoing this process. To voice your concerns and fears. Many hospitals and surgeons that perform this type of surgery can detail where these meeting are held and when they meet.

I was told that I would have to give up caffeine and carbonated beverages when I had my surgery (RNY). So I went cold turkey when I started my 6 month medically supervised weight loss program. I had a 6 diet coke a day habit for several decades. I found it interesting that going cold turkey on these cokes along caused me to lose 20 pounds. The other thing that I found interesting is the fact that my body went through a severe withdrawal when I went cold turkey. This lasted for about a week and I sustained severe headaches during that time. I understand that many people go through this withdrawal syndrome. It is best to get this over with long before surgery than compound these effects with the effects of surgery. It would like getting a double whammy.

It is difficult to get in the Protein in the beginning. I tried mixing in the powders by hand shaker. That didn't provide the proper consistency and as a result tasted very bad. I began using a Ninja (single serving) size blender. That mixed the powders well. It also gave me the chance to add other ingredients to the Protein shake. When you add a banana to the mix, it dramatically improved the taste of the protein shake. There are a variety of protein powders out there. The secret is finding one that taste the least offensive. For me that was Muscle Milk Light (vanilla Creme). Another problem that I encountered was that immediately after surgery, I became lactose intolerant. So I could not rely on milk or milk products for protein. This condition went away after a couple months.

I had RNY surgery 20 months ago. I was in a weight loss mode for 7 months and then very naturally transitioned into a maintenance mode. In the maintenance mode, it is very important to be happy. I try to find a balance with my meal, Protein, liquid, and Vitamin requirements while at the same time find an approach that I can live with in the long term without regaining the weight back again. I asked my nutritionist "Why are people successful with weight loss after surgery, only to regain much of the weight back after surgery?" She said it is probably due to snacking between meals. I took the approach of eating high protein homemade chili and Soups as my meals. As a result when I worked my way up to 1 cup per meal, I was consuming around 65 grams of protein solely from my meals. I hate Protein shakes. As I obtained more and more protein from my meals, I could phase out my use of protein shakes. I still supplement protein. But in my case it is either a cup of hot cocoa (no sugar added) or a blueberry smoothie each day. They make me happy. For me the other part of the equation is what to snack on. Protein is a good snack. But for me, the best snack is items that contain fats. This is because fats take away hunger. I make homemade whip cream. I substitute Splenda in place of sugar. (I do avoid sugar almost completely.) I have one cup of coffee each day with a very large scoop of whip cream. Another item that I use is Adkins treats. They contain fat and substitute sugar alcohol in place of sugar. I generally limit my calorie intake to 1300-1500 calories per day. But I also monitor my weight each day. So long as my weight is stable I am happy. Everyone is different, what works for me may not work for you. The important thing is to find your happy state. Something that you can live with for the rest of your life, while still maintaining your weight loss. For me experimentation was the answer.

Good luck and let us know how you are doing on the other side of surgery.

Immediately after surgery, your body does not need very much food. This is because it is converting fat cells into the energy your body needs to function. 600-900 calories per day sounds good. The important thing after a gastric bypass surgery is Vitamin, Protein and liquid requirements. It sounds like you are meeting your protein, liquid and exercise requirements. What about Vitamins? They need to be spaced out during the day. One of the other factors that can limit weight loss is the effects of medicine. Are you taking any medication that can impact weight loss?

I took B12 shots for about a year (one each month). I never noticed a decrease of energy levels as I approached the end of the month. Sometimes I took the shots several days late and I still did not notice any loss in energy levels.