James Marusek

NSAIDs should be avoided after sleeve surgery. They can lead to severe ulcer problems.

The answer will vary somewhat by the type of surgery that you are planning to have. I had RNY gastric bypass, so I will answer this question from my perspective. First off you taste buds may change right after surgery. The protein shake you are currently consuming may taste simply awful after surgery. Many experience problems drinking protein shakes. I hated them. But in the beginning I drank them, three 16-ounce protein shakes a day, in order to meet my protein requirements. You do not have to like protein shakes only tolerate them. There are many varieties of protein shakes available today. Experiment until you can find one you can tolerate. I used Muscle Milk Light (Vanilla Creme) powder blended with water and a half a banana. That worked for me. But on the opposite end of the spectrum, you might try premixed Isopure. Without sufficient protein, your body will scavenge protein from other areas of your body, such as your muscles. Protein is extremely important after surgery as its job in the body is to build and maintain tissues including your body's major organs and skeletal muscles. Protein deficiency, when continued over a long period of time can cause a disease known as protein caloric malnutrition. Common symptoms are poor healing, fatigue, hair loss and muscle wasting. Immediate post op, protein promotes healing of the staple line and incisions. Your daily protein requirement is met by a combination of the amount of protein you obtain from food combined with the amount of protein from protein supplements (protein shakes, protein bars). Right after gastric bypass surgery, the volume of food you consume is minuscule (2 ounces) per meal. But as you get further along, the meal volume increases. Therefore you have a very important option available to you. As a result, you can begin to reduce your reliance on protein shakes if you concentrate on consuming high protein meals. I went from 3 protein shakes a day, down to 2, down to 1 and eventually none when I reached 1 cup per meal at a year and a half post-op.

It is very common to feel anxiety prior to major surgery. I would recommend three things. 1. Take a good before photograph of yourself, so that you have something to compare to after surgery. Many times we are blind to our obesity. We do not see ourselves. Therefore when the weight begins to drop off rather dramatically, we question if this is really happening. Photographs are a good visualization of our success. Many people carry a before and after photo with them, just to remind themselves of their success. 2. Walk 30 minutes each day, every day until surgery (or equivalent exercise). Walking helps the recovery process go smoothly and minimized the pain levels from surgery. 3. Wean yourself from caffeine and carbonated beverages now. After I gave up my 6 diet coke a day habit, I suffered from a week of severe withdrawal syndrome consisting of severe headaches and body aches. I was miserable. You don't want to combine the effects of caffeine withdrawal with the effects of surgery.

Human fat is a very good insulator. As you lose weight (fat), this insulation barrier will get thinner. Since the OP had surgery on 7/3 I doubt that this is the main reason. But over time, this condition will become more pronounced. Prior to surgery I was very warm blooded. I would drive in my car in the winter with the windows down even when it was snowing. I was just a little too hot. But after surgery, I am experiencing the other extreme. Thank God, someone invented hand warmers. When shoveling snow in the winter, they are a blessing.

As I lost weight, the fat that normally cushioned my knee joints disappeared. So at night when I slept on my side, it felt like I was rubbing my bones together at my knee joints. I found that by placing a pillow between my knees during the night, it felt good, so that is how I sleep.

I am 6 years post-op RNY gastric bypass. Like you said everyone has different taste. The following are the variety of drinks that I have found enjoyable. Water with ice cubes. No sugar Crystal Light [not a great fan but I served me well at the very beginning when I had to drink something with some flavor and no sugar.] Fine English teas such as "Royal Wedding Tea" by Harney and Sons. A drink called "Bai" that comes in bottles. [I generally buy these by the case when they are on sale.] Hot cocoa during the winter [I use Nestle Nesquick (No Sugar Added) with milk] Hot Lipton tea with a half a squeezed lemon to which I added a no calorie/low calorie sweetener. And since I am several years post-op and in the Maintenance mode, I have integrated drinking a cup of coffee each morning into my routine. I sweeten it with a no calorie/low calorie sweetener and add a couple tablespoons of whipped cream to the top. The whipped cream I make from scratch using heavy whipping cream and for a whip cream sweetener I use Spenda. I have found that it is a good way to start my mornings because it contains fats which minimize hunger.

This article explains dumping syndrome: Dumping syndrome The symptoms of early dumping syndrome are: * Feeling bloated or too full after eating * Nausea * Vomiting * Abdominal cramps * Diarrhea * Flushing * Dizziness, lightheadedness * Rapid heart rate __________________________________________ Since you have a blood glucose meter, when you begin to feel very light headed and have a high heart rate, you might take a blood sugar reading. If it is very low say in the 30's or 40's then you may have a handle on the cause. ___________________________________________ Something you said causes me concern. You said, "🙄 but I’ve puked more this past three months than my whole life" I spun this around last night and perhaps this is the symptom that should be focused on. If you have constant nausea since surgery, there is a problem. It shouldn't be. It is abnormal. According to the Internet: Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and noncompliance with a gastroplasty diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%. Although no unifying explanation for the etiology of anastomotic ulcers exists, most experts agree that the pathogenesis is likely multifactorial. These ulcers are thought to be due to a combination of preserved acid secretion in the pouch, tension from the Roux limb, ischemia from the operation, nonsteroidal anti-inflammatory drug (NSAID) use, and perhaps Helicobacter pylori infection. Evidence suggests that little acid is secreted in the gastric bypass pouch; however, staple line dehiscence may lead to excessive acid bathing of the anastomosis. Treatment for both marginal ulcers and stomal ulcers should include avoidance of NSAIDs, antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition, H pylori infection should be identified and treated, if present. So if ulcers are the problem, then: * Make sure you are off all NSAIDs. NSAID's are in many produces like aspirin, Excedrin and a hundred other over the counter meds. * Use a proton pump inhibitor. One common form is Omeprazole (or over the counter Prilosec). My surgeon had me take this for the first year after surgery, just to allow my stomach to heal properly. There are a variety of proton pump inhibitors, some individuals on this website found some types were more effective than others. * Have yourself tested for Helicobacter pylori infection. This is a fairly common infection. Over half the people in the world have it. It is also hard to kill. Sometimes you have to go through several regiments of antibiotics to kill it. Your primary care physician should be able to give you this test. I think I read somewhere that the urea breath test is more accurate than the blood or stool test. Here is a link: What Is H. pylori?

There are two types of dumping, early and late. I had plenty of experience with early dumping. Anytime I ate a little bit too much, it would lead to early dumping. Because of this I learned to detect the signals my body gave me to tell me that I was at the edge, such as hiccups, sneezes etc. and then I would just abruptly stop eating not one more bite. But I never experienced high blood pressure or fainting symptoms. There is another type of dumping syndrome called late dumping or reactive hypoglycemia. The following link explains the two types. I met someone with this late dumping condition at a bariatric surgery support group meeting. He was not diabetic prior to surgery but after surgery, he experienced severe reactive hypoglycemia. He even fainted a couple times before he figured out this was a problem. Once he knew the problem, he knew what he had to do whenever he felt dizzy afterwards and found he could easily manage and live with that condition. Dumping Syndrome After Gastric Bypass Surgery But when I looked at your meal, I did not see anything to trigger this reaction. If you had a blood sugar monitor, it might be interesting to know what your blood sugar levels were during your dizzy episodes.

You may want to run this by your surgeon's office. Generally when we leave the hospital we are given discharge directions. One of the items on the sheets is called "When to Call Your Physician". On mine item number 6 reads: "Chest pain, rapid heartbeat and/or dizziness." ------------------------------------------------------------------ Since your physician discussed leak, I did an internet search and found the following: Anastomotic Leak After Gastric Bypass Surgery Symptoms can occur a bit differently in each person. They can include: * Fast heart rate * Fever * Chills * Stomach pain * Chest pain * Shortness of breath (rapid breathing or difficulty breathing) * Fluid leaking from an incision site * Nausea and vomiting * Pain in the left shoulder area * Low blood pressure * Less urine * General feeling of discomfort (malaise) The symptoms of anastomotic leaking after gastric bypass surgery may look like other health conditions. See your healthcare provider for a diagnosis.

It may be a function of the type of surgery. I do not know if lap band surgery produces a feeling of being full.

The vitamin requirements will vary by the type of surgery. Sleeve patients require the least. Duodenal Switch patients have the most. And RNY gastric bypass patients are in-between. After RNY surgery, you are required to take many vitamins for the rest of your life. This is because you body no longer synthesizes vitamins from food. That part of your stomach has been cut away, so this daily requirement is extremely important. Vitamin chemistry is important for absorption. Calcium supplements should be calcium citrate. There are also different chemistries of B12. I use the sublingual B12 and was told to use methylcobalamin. You cannot use a time-release version of B12. According to my nutritionist,, if you are taking iron supplements, it must be ferrous sulfate for the best absorption. Gummy vitamins are not absorbed properly and should be avoided. It is important to put a 2 hour separation between the vitamins that contain iron and those that contain calcium. So in my case I found that what works best for me is to take the iron supplements just before bedtime. I put my vitamins in a weekly pill container. I have one container for the morning and one for the night. And I use a very small glass finger bowl for my calcium supplements. I put my calciums in the bowl in the morning and take them throughout the day, a couple every two hours. If I am up and about I put my calciums in a ziplock bag and carry them with me.

I am 70. Had the surgery 6 years ago. It was one of the best decisions I ever made.

After weight loss surgery, they give you blood thinners to prevent the formation of blood clots which can be life threatening. Blood thinners make your body very susceptible to bruising. It will take several weeks after you stop taking blood thinners for your body to return to normal. Also if you have the surgery laparoscopically there will be several incision points. I think I had around 7 of them. One is exceptionally large because that is where the most surgery was done at. Most of these incision point will heal in a month or two but the main one may take about a year before you can no longer feel the incision bump.

According to the Internet, bariatric surgery produces an increased incidence of kidney stones. Calcium and oxalate are naturally absorbed by the gastrointestinal or GI tract. Following weight loss surgery, patients tend to absorb less calcium from their GI tract. The end result is that higher levels of oxalate tend to occur in the urinary tract. Under the right circumstances, the oxalate will form crystals, which in turn can aggregate to form kidney stones. So you are right to make sure that you stay hydrated and meet your daily fluid requirements. Over the years there have been several individuals on this site that have reported getting kidney stones after bariatric surgery. Oxalate stones are a potential side effect of gastric bypass surgery. Consuming water throughout the day, limiting your sodium intake, and eating a diet rich in plant-based protein are all healthy strategies that can help you manage your weight, and prevent kidney stones. Source: https://www.drbrianstork.com/blog/tips-kidney-stones-weight-loss-surgery/

Good luck on your journey.

O.K. , So you had surgery just a few days ago on 13 May 2019. It is common for your taste buds to change after surgery. Be willing to experiment. After surgery, my taste buds changed dramatically. Even water changed. In the hospital it tasted excessively chlorinated and I could not drink it. So I experimented. Sugar free popsicles became my best friend. Some individuals find hot or cold can help with fluids. For me, I found that I could tolerate flavored water. So I began using Crystal Light. I also found a new drink Bai which I liked cold. In the winter, I found that I tolerate hot drinks such as piping hot cocoa. But you have to use the "No Sugar Added" variety. Also fine English teas were very good.

If you had weight loss surgery in 1984 it would seem rather unusual for you current problems to be related to your weight loss surgery.

One way to deal with dry mouth is to use biotene mouthwash.

According to my hospital discharge papers, one of the conditions to trigger a call to the surgeon's office Is: Chest pain, rapid heartbeat and/or dizziness.

According to the internet: Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and noncompliance with a gastroplasty diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%. Although no unifying explanation for the etiology of anastomotic ulcers exists, most experts agree that the pathogenesis is likely multifactorial. These ulcers are thought to be due to a combination of preserved acid secretion in the pouch, tension from the Roux limb, ischemia from the operation, nonsteroidal anti-inflammatory drug (NSAID) use, and perhaps Helicobacter pylori infection. Evidence suggests that little acid is secreted in the gastric bypass pouch; however, staple line dehiscence may lead to excessive acid bathing of the anastomosis. Treatment for both marginal ulcers and stomal ulcers should include avoidance of NSAIDs, antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition, H pylori infection should be identified and treated, if present.

I hope you get over your cold. Not sure what is causing your ravenous hunger? When on a liquid diet some people begin to miss their ability to chew foods. This process is ingrained into us and chewing causes our bodies to release digestive fluids in our body to help the process. Others just miss the act of eating, it is a type of phantom hunger. After my RNY surgery I completely lost my hunger for about a year but that loss of hunger did not start until I transitioned into the solid food phase. I am not sure if sleeve patients also have that condition. Anyways you are still very, very early in the process, so don't take hunger as any kind of sign for your future. Many experience problems drinking protein shakes. I hated them. But in the beginning I drank them, three 16-ounce protein shakes a day, in order to meet my protein requirements. You do not have to like protein shakes only tolerate them. There are many varieties of protein shakes available today. Experiment until you can find one you can tolerate. There are many different types of formulations on protein shakes. I used Muscle Milk Light (Vanilla Creme) powder blended with water and a half a banana. That worked for me. But on the opposite end of the spectrum, you might try premixed Isopure. Without sufficient protein, your body will scavenge protein from other areas of your body, such as your muscles. Protein is extremely important after surgery as its job in the body is to build and maintain tissues including your body's major organs and skeletal muscles. Protein deficiency, when continued over a long period of time can cause a disease known as protein caloric malnutrition. Common symptoms are poor healing, fatigue, hair loss and muscle wasting. Immediate post op, protein promotes healing of the staple line and incisions.

As you lose weight, the chemicals and hormones that were stored in your fat cells are being released into your body. These will pass through your kidneys and are expelled in your urine or through your sweat. But they can generate a flush of hormones during the weight loss phase. They should simmer down once you transition into maintenance. It is important to meet your daily fluid requirements, because it take fluids to flush these hormones from your system.

No blood thinners pre or post op so that is not it. I guess it could be the less padding lol That is strange! Most surgeons require patients take blood thinners right after surgery to prevent blood clots from forming. I had to take Lovenox (enoxaparin) for about a week after surgery. It stays in your body a long time and my whole body was covered in bruises for several months after surgery.

@Frustr8 One other thing causes me a little confusion. You said that your surgery was 8 months ago but you ticker says that it was on 2/7/2014. Is this your second time around? Did you go from a sleeve to bypass or ? After my RNY surgery they put me on Omeprazole for a year. This was to allow my stomach to heal properly. It is routine. After the year, I was taken off and I have no signs of GERD anymore. I went off around 5 years ago. According to the Internet: Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and noncompliance with a gastroplasty diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%. Although no unifying explanation for the etiology of anastomotic ulcers exists, most experts agree that the pathogenesis is likely multifactorial. These ulcers are thought to be due to a combination of preserved acid secretion in the pouch, tension from the Roux limb, ischemia from the operation, nonsteroidal anti-inflammatory drug (NSAID) use, and perhaps Helicobacter pylori infection. Evidence suggests that little acid is secreted in the gastric bypass pouch; however, staple line dehiscence may lead to excessive acid bathing of the anastomosis. Treatment for both marginal ulcers and stomal ulcers should include avoidance of NSAIDs, antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition, H pylori infection should be identified and treated, if present. So just to make sure we are covering all the bases. Omeprazole is a proton-pump inhibitor. It is not the only one. Some individuals on this site have problem with omeprazole and found others that work more effectively. NSAIDs are found in a number of products such as aspirin, Excedrin and many, many others. You have to stay away from these. My mother used Excedrin as a mild pain reliever for several years. But the problem was she was taking 5 or 6 times the recommended daily dose. She started hemorrhaging internally because she developed an internal ulcer. They had to give her blood transfusions as a result. I took away all her Excedrin and that problem was solved. The third item is H pylori infection. This is a very common infection. About half the people in the world have it. It is very hard to kill. Sometimes it takes several antibiotic treatments to put it down. There have been several people on this website that have serious problems with ulcers. When they were finally check for this infection they found that was the root cause of their problems.

@Frustr8 So what is wrong? You are 8 months post-op RNY gastric bypass and you cannot tolerate to eat solid foods. You should have transitioned into solids several months ago. What does you doctor or nurse practitioner feel the problem is? It might not even be related to the surgery! Many of your past post have been fairly upbeat. Is this just a bad stretch along the road or has your inability to transition to solids been there all along?. I am 70 years old and you are three years older than me. What do you think the problem is? Give me some perspective.