James Marusek

Right after surgery, I lost my ability to swallow large pills and I had to crush them. The horse-size calcium tablets were the worse. It was like eating chalk. The only way I could down these was by mixing them with crystal light and drinking them down. Because they formed a paste at the bottom of the glass. I had to remix these and chug them down several times. Luckily my inability to swallow lasted only a couple months and then I was back to normal.

Your fat cells store chemicals. So many of the chemicals that you took throughout the years, may be coming to the surface. 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 glands. 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.

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. Carafate is a sucralfate. I was on it for a while after surgery. My surgeon had prescribed taking Omeprazole (over the counter Prilosec) for the first year after surgery to give my stomach a chance to heal properly. Omeprazole is a proton-pump inhibitor. So this might be of help to you. Check with your doctor. Also avoid any aspirin or products that contain aspirin or other NSAIDs. And make sure that you were tested for H Pylori infection. A high percentage of individuals have this infection and generally don't even know it until it shows up with a vengeance after bariatric surgery.

It is common during the first few weeks after surgery to be unable to meet the daily protein requirements. This is because your stomach is in a major heal mode. Just keep working towards that goal and you should be able to reach it shortly.

It adds more protein.

Good luck on your surgery tomorrow and remember after the surgery to Walk, Walk, Walk. It will help to make the pain go away.

When did you have your surgery? Some individuals suffer constipation right after surgery when they are in the full liquid diet stage. For me is was near the end of the weight loss phase around 6 months in. If you recently had the surgery, it is important to take some probiotics. Generally when you are in the hospital, you are given antibiotics to kill any bad bacteria floating around the hospital. These antibiotics not only kill the bad bacteria but also the good bacteria in your gut. This good bacteria help with processing food. Therefore you need to reestablish the colonies of good gut bacteria after you are off the antibiotics. Walking is the best way to relieve gas pain.

Welcome and let us know if we can be of any help.

Most insurance companies, use the weight and BMI when you entered the 6 month weight loss and exercise program rather than your final weight at the end of the program. But a challenge is a challenge and the weight you lose pre-op adds to the weight loss you will achieve after surgery. So in a way it is a win-win situation. Go for it.

I don't think I would micro-analyze this. Just make sure you meet your daily fluid requirements. During the first few weeks some people find it difficult to meet their fluid and protein goals. This is because their stomach is in a major heal mode. Just keep working towards those goals. I never had a daily fluid upper limit, and as far as I can determine, I turned out fine.

Patience. There is always a lot of confusion at this stage. My hospital called me and said I was approved and scheduled my surgery. I received a note from my insurance saying I was approved. Then I received a letter from the insurance that said my surgery was not approved. Apparently the confusion was that there are two approval forms. One that approves the surgery and another that approves the number of days you are allowed to be in the hospital. The second one is really unknown until after the operation and the surgeon can gauge how the recovery process is going. It is a totally confusing process.

At the hospital they gave me a small plastic spoon. It made it difficult to eat fast. I visited several stores and found one that sells these same size spoons but in metal. I have been using it for 5 years now and I don't really worry about eating too fast. On a side note for microwave ovens. If you warm food in a normal oven or on an electric range and compare it with food heated in a microwave, the microwaved food returns to room temperature much quicker. That is my personal observation. it is probably related to why it is not recommended to cook meat in a microwave oven and only use it to reheat meat already cooked the conventional way because of microwaves do not kill bacteria efficiently. http://www.nytimes.com/2007/05/22/health/22real.html

Normally strictures begin to appear at around 4 weeks so you are in the right range. Best to let your surgeon's office know about your problem.

Congratulations.

During the first few weeks after surgery many people find it difficult to meet their daily protein requirement. That is because your body is in a major heal mode. Just keep working towards that goal and you should be able to get there. 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. If you tried all the various varieties and still are unsuccessfully, then there is the fallback of fortified milk. 32 ounces of 1% milk fortified by adding 1 cup of dried milk provides 56 grams of protein. It also takes a dent out of meeting the fluid requirements. Mix up a pitcher and drink a little throughout the day. 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.

I wonder if this is an exaggeration! In your case 30 pounds down in 6.5 weeks sounds good for a sleeve patient. Individuals lose weight at different rates. Individuals with a lot of weight to lose can lose more pounds per day than someone with less weight to lose. The type of surgery also matters. I had gastric bypass surgery and my weight dropped off swiftly and I transitioned into the Maintenance phase at around 7 months. Sleeve patients lose weight at a slower pace but they transition into Maintenance much later, somewhere around 2 years.

Welcome. Normally you local primary care physician (PCP) only directs you to the bariatric surgeons. I had surgery at a Center of Excellence for Bariatric Surgery. These Centers of Excellence are available in many states in the U.S. The Centers of Excellence provide a complete support for the surgery. There are many components that require a range of specialist beyond just a surgeon who specializes in Bariatric Surgery. They include nutritionist, psychologists, a hospital that specializes in bariatric surgery, staff that work insurance issues, pre-op testing, weight loss and exercise programs, bariatric surgery support group meetings, five years of post-op follow-ups. It is like a "full meal deal", no pun intended. So you might begin by finding out where the closes Center of Excellence is and when you see your doctor direct him/her in this direction.

Before surgery, I never really looked at myself - so I didn't even see how obese I really was. Since I was the photographer in the family, I rarely occurred in photographs. So it can be hard to see the result. For me the greatest feeling was the drop in clothes sizes. In shirts I went from a size 3X down to a size small. So I predict that very very soon you will be able to go into high end clothes shops and buy, buy, buy. You will need to anyways because you will have to totally replace your wardrobe.

I had RNY gastric bypass and the number and quantity of vitamins that I take is several times that of sleeve patients. So I generally take inexpensive vitamins that I buy in bulk as Sam's Club. I take Citracal for my calcium requirements. I take Centrum for my multivitamins. I take Sam's club brand sublingual vitamin B12.

Several years before surgery, my snoring would keep my wife awake all night long. She was a light sleeper and she really needed her sleep. A few months after surgery, I woke up in the middle of the night and found my wife hovering over me in bed. I asked her what she was doing. She said I was sleeping so quietly, she thought I had passed away and she was trying to see if I was still breathing.

Congratulations.

Good luck on the start of your journey.

Goal weight is an artificial number. I think my surgeon told me that I could reach 190 pounds. I was happy with that. But in the end I dropped almost down to 140. As far as a goal, I would shoot for the high side of normal BMI. Normal BMI 18.5-24.9. So for your height of 5 foot 2 inch that would correspond to a goal weight of around 135 pounds. The reason why I would select that as a goal is because individuals on the high side of normal live the longest. It is important to keep a little fat in your body because when you have a very, very serious illness or accident, you need that reservoir of fat to keep you alive until your body recovers. It is O.K. to drop below that level for a little while to compensate for a small amount of weight gain as you progress in Maintenance phase.

Several thoughts here. After my surgery, my doctor prescribed omeprazole for the first year after surgery so that my stomach would heal properly. In the States there is an over-the-counter version called Prilosec, so you don't even need a prescription for this medicine. Antibiotics not only kill the bad bacteria but also destroy the good gut bacteria. It is important to reestablish these colonies of gut bacteria after you get off the antibiotics. This is done by taking probiotics. Some patients develop a problem called a stricture. This is a common problem that can be identified and corrected using an upper GI endoscopy or EGD (esophagogastroduodenoscopy) followed by a balloon dilation. http://alohasurgery.com/strictures/ According to my hospital discharge directions, one of the times to contact your surgeons office is if you have "an inability to eat or drink". That is you.

If you have severe acid reflux, it is best to have gastric bypass over sleeve surgery. The problem is that if you go for the sleeve and then after surgery GERD appears, then the main option is to go from sleeve to Gastric Bypass. These are expensive operations. I had severe acid reflux (GERD) prior to surgery and went with gastric bypass. One of the factors in that decision was that if I went under the knife once, I sure did not want to go under again. Once is enough for me.