James Marusek

You will need a way to get home. You will not be able to drive. Also the scripts for prescription medicine such as blood thinners are generally written on the day you leave the hospital and you will need to get those filled as you go home.

Right after surgery, the complexity of meeting all the daily requirements were mind boggling. It seemed like there were not enough hours in the day. But as I progressed, I developed a very systematic approach that made the process easier. [For example, putting all my calcium tablets in a small finger bowl in the morning and then taking them periodically over the day helped. And if I was up and about, putting them into a zip lock bag and carrying them along with me helped.] The other challenge was adapting to the changing requirements post-op. There are many transitions such as going from full liquids, to pureed foods, to solid foods that one passes through. Some of these can present difficulties. This is an ever changing road. Every time that you think you have it, there is another curve ahead. Realizing that there were two phases, the Weight Loss phase and the Maintenance phase, and each one had a different approach was important.

Al Gore has been saying that the science has been settled for many decades. He is not a scientist. But the scientist that support the man-made global warming theory have refused to debate the subject, saying the science is settled. Generally that means that the hypothesis stands on very weak legs. If it is really settled, it would be a slam dunk to debate and debate would provide a critical evaluation looking at the subject from all angles - that is what all of science is all about. The most accurate temperature data set comes from satellites. Global temperatures have flatlined according to the satellite data from 1998 and the same time carbon dioxide levels have risen dramatically. A 20 year pause is not weather, it is climate. The climate has been changing for thousands of years without the aid of mankind. The earth has experience many great climate disasters over the years. http://www.breadandbutterscience.com/A_Chronological_Listing_of_Early_Weather_Events.pdf

The knot near my stomach at the main incision site took about a year before I could no longer feel it.

The first thing that came to mind is that you might have a stricture. This is fairly common after bariatric surgery. The normal solution to correct this problem is to have a upper gastrointestinal endoscopy. This process will allow them to observe the obstruction and correct it with a ballon dilation at the same time. So since you are scheduled to have an endoscopy, you will soon know if this is the cause of your problem. https://renewbariatrics.com/gastric-sleeve-ulcers-stricture/ [But since you have posted about your problem before and I do not recall your posts, there may be other issues at play. So perhaps you have already had an endoscopy in the past.]

Congratulations.

According to my discharge directions "avoid alcohol (it's empty calories, and irritates the new stomach)". There are two phases to weight loss surgery - the weight loss phase and the maintenance phase. The weight loss phase is short - perhaps 2 years for sleeve patients. It is important to maximize your weight loss during the weight loss phase, so I recommend not drinking an occasional glass of wine during the first 2 years.

Welcome and good luck on your journey into becoming normal (BMI).

Congratulations Yes becoming normal BMI is a realistic goal.

It took me 6 months before I reached my happy state, when all the problems seemed to melt away so hang in there.

They will eventually disappear. I think mine were completely gone after a year or two.

Welcome. I am 5 years post-op RNY gastric bypass surgery and I think the decision to have surgery was one of the best decisions that I ever made. After surgery, I completely lost my hunger and I did not find it difficult to drop 120 pounds. My hunger returned after a year but it was not at the same level as before. But surgery is a tool and you do need to work at it each day. The main reason why I had the surgery was because I had a number of severe health conditions that were cause by my obesity and I wanted them gone. It was truly marvelous how quickly these health issues went into remission after surgery and stayed there. One of your concerns was I die and my daughter is left without a mother all because Of my unhealthy relationship with food. You might look at it from a different perspective. Suppose you continue on being overweight and this causes severe health issues that cause you to die prematurely because you chose not to have the surgery and your daughter is left alone without a mother. So there are two sides to this coin. Anyways, I will turn 70 this year. I have stamina of when I was 30. Stamina is the ability to perform physical work. This last year I built a log cabin playhouse for the grandkids. It was a teaching experience for them because I made them do part of the work. This is a link to the playhouse. http://www.breadandbutterscience.com/Log_Cabin_Playhouse.pdf

Dumping syndrome is a bit like a learning experience. Once you have an episode, you never want to repeat the process. There are pre-triggers before you reach full dumping. They can be things like hiccups, sneezing, food will suddenly taste horrible in an instant, mucous. When you hit a pre-trigger, you just stop eating - not one more bit. Otherwise, you will be miserable for around 4 hours. The best way to relieve this situation is to go to the bathroom and force yourself to vomit up your food and empty your stomach. It is also important to not eat for two hours before bedtime. Because when you have dumping at night, you will not be able to sleep. The horizontal position just aggravates the problem. So I generally sit by the TV for a few hours until it passes.

I had RNY gastric bypass surgery and I completely lost my hunger for a year and then it returned but not near the same level as before. I am not too sure if sleeve patients have the same experience. Generally the absence of hunger kicks in when you reach the solid stage, so be a little patient until then.

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. The fluid requirement is met by a combination. It is not only the water that you drink each day. But also the water you drink when you take your vitamins and medicine. It is the milk you drink. It is the fluids content of the protein shakes. It is the water component of the soups you take. It is met by flavored water such as Crystal Light. It is met by sugar free popsicles. It is met by tea and decaf coffee. It is a combination of all the fluids that you consume during the day. It is important to get at least 30 minutes of walking each day. But that does not have to be in a gym. If you are walking a lot as a medical student between classes and in your part time job, that can count. You might want to get a pedometer and see how many steps your are walking each day. Also I found going up and down stairs gives more exercise than walking on the flats.

If you are 3 months out, it is likely you have already restored these colonies because some foods such as yogurt contain natural probiotics. https://www.livestrong.com/article/281319-yogurt-brands-containing-probiotics/

Generally when you went into the hospital for surgery, they routinely give you antibiotics to kill any germs that might try and infect your wound. The problem is that antibiotics not only kill the bad bacteria but also the good bacteria you have in you gut. Therefore after surgery it is important to reestablish these colonies of good gut bacteria. That is where probiotics come in. That is why it is important to take some probiotics for a few days after you are off the antibiotics.

You now have a much smaller stomach. When you had a large stomach, it would hold a lot of gas. But now if you drink with a straw or drink carbonated beverages, you will put gas in your small stomach. So it is best if you don't. But you could drink water from a bottle so long as you don't use a straw. I put some of my experiences in a short article. You might find it interesting. http://www.breadandbutterscience.com/Surgery.pdf

I had RNY gastric bypass surgery and for the first month my meal volume was limited to 2 ounces per meal. That is almost nothing. With this minuscule amount of food, it is next to impossible to meet your protein daily requirements by food alone, so therefore you need to rely on supplements such as protein shakes. I found that if I met the fluid, vitamin and protein requirement, I had all the energy I needed. In your case since you are very much on the go, you might need a little extra protein. So I guess I am saying don't stress on the meals, but rather put your focus on meeting your fluid, vitamin and protein goals. If you are weak, it can be due to dehydration. If you are weak it can be due to an electrolyte deficiency (such as potassium and sodium). 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.

The beginning can be really rough. Many people find it difficult to meet their protein and fluid requirements during the first few weeks. This is because your body is in a major heal mode. Just keep working towards your daily goals and you should be able to get there. What type of surgery did you have? The three most important elements after weight loss surgery are to meet your daily protein, fluid and vitamin requirements. Food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight.

Generally bypass surgery should not degrade lung function. In my case it actually improved my lung function. I had asthma and several years after surgery, I was able to completely get off all my asthma prescription medicine. Surgery might affect lung function right after the surgery because of blood clots but at 5 months post-op, I would think you are well beyond the danger stage. After surgery, they recommended that I use a spirometer. If you still have the one you were given, you might pull it out and measure your lung capacity. A spirometer is an apparatus for measuring the volume of air inspired and expired by the lungs. A spirometer measures ventilation, the movement of air into and out of the lungs. The spirogram will identify two different types of abnormal ventilation patterns, obstructive and restrictive.

Many people find it difficult to sleep comfortably immediately after surgery. Some found sleeping on a recliner worked for them. The problems gets better quickly. It should be resolved in a couple days. In the mean time find what is the most comfortable and works for you. Later when you have lost a lot of weight, you might want to slip a pillow between your legs when you sleep on your side at night. There is nothing more unnerving than feeling the bones at your knees rub together.

As we lose weight, our clothes sizes drop. This includes not only the size around our waist but more subtle changes as well such as shoe size. I started receiving comments as I lost weight that I looked like someone who was emancipated from a concentration camp. Anyways I looked at myself in the mirror and I could see where the comments came from. It was my sleeve length. As I shrunk, my sleeve length grew. I looked like character Dopey in Disney's Snow White and the Seven Dwarfs. My sleeves hung down well past my fingertips. Although I had changed most of my clothes, I hung onto my coats and jackets. I had a personal attachment to them because generally they were the most expensive items in my wardrobe. So I went and replaced these, the comments stopped and I then lost another 20 more pounds.

Congratulations.

Totally agree.