James Marusek

Good luck with your surgery and check back with us when you are on the other side and let us know how the surgery went.

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. Some protein shakes can be bought ready made, but generally I bought the protein powder in bulk over the internet. I blended the shakes using a Ninja blender (single serving cup). 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.

There are two phases to gastric bypass surgery. These are the weight loss phase and the maintenance phase. The strategy of these two phases are different. I described my experience in the maintenance phase in the following article. http://www.breadandbutterscience.com/Surgery2.pdf

I was also disheartened to learn that I had to go through a 6 month diet and exercise program to qualify for surgery. But having gone though that process, I can see that it was positive experience. It taught me about food journaling. I tracked everything I ate and learned what to avoid. I also developed a routine of walking each day. I attended bariatric surgery support group meetings and learned from others who were going through he process or what to expect after the operation. I was impatient but good came out of this process.

Congratulations.

Confusion can be caused by a variety of problems. This website lists 80 causes. https://www.healthline.com/symptom/confusion The ones I would focus on are numbers: 1, 7, 27, 28 and 62. #1 Hypoglycemia (low blood sugar). Many people develop a type of hypoglycemia after bariatric surgery called reactive hypoglycemia. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass This can also occur if you were diabetic prior to surgery and did not reduce your prescription medicine after surgery. #7 Low blood pressure. If you had high blood pressure prior to surgery and were taking prescription medicine for that condition. This may be an indicator that you may need to come off some of that medicine. # 27 Hypokalemia (low potassium levels). Make sure you are taking vitamin/mineral supplements for potassium. # 28 Hyponatremia (low blood sodium). Make sure you are getting enough electrolytes. # 62 Beriberi (B1 deficiency). I would also lump B12 deficiency into this one. After Gastric Sleeve surgery, my surgeon recommended 100 mg. Thiamine (vitamin B1) weekly and 500 to 1000 micrograms sublingual B12 weekly. While you were in the hospital, you were probably given a shot of B12 which is good for one month. Since you are 4 weeks post-op that is probably wearing off and you need to begin taking B12 weekly. I am not a doctor, so take everything I say with a grain of salt. But those are the areas I would explore.

Is eating whole eggs better than eating egg whites for muscle protein synthesis? An article that I read this morning points in that direction. People who do resistance training to get a more muscular physique are encouraged to eat protein-rich foods or supplements post-exercise to help add muscle. Since egg protein is about as good as it gets, conventional wisdom has been that you should eat egg whites (which contain about 60 percent of an egg's protein complement), but avoid the yolk. However, a recent study questions whether this is really the best advice. Writing in the American Journal of Clinical Nutrition, Dr. Nicholas A. Burd from the University of Illinois at Urbana-Champaign and colleagues described a study comparing the effect of consuming whole eggs vs only egg whites on muscle protein synthesis post-resistance training. They examined rates of muscle protein synthesis in 10 young men (average age 21 years) who were trained in resistance exercise. The study concludes: Although it has long been vilified, it seems that the egg may have more to offer, from a muscle perspective, than we previously realized. As a relatively low-cost and nutrient-dense source of protein the egg rightfully deserves some attention as we look for sources of dietary protein with an expanding global population. https://www.acsh.org/news/2018/01/08/gain-muscle-eat-whole-eggs-not-just-whites-12376

Stalls are so common that someone here coined the phrase "Embrace the Stall". Look for other non scale victories (NSV). I found that as I lost weight, my cloth sizes dropped. I would go to store and buy a shirt that was so tight that if I took a deep breath, I could pop a button. A week later the shirt fit like a glove. Over my weight loss, I went from a size 3X in shirts down to a size Small and from a size 46 in pants down to a size 33. Although I was not normally into clothes, during the weight loss phase, the drop in clothing sizes brought me great joy.

After the surgery, the incision points are very tender at least for the first month. Coughing and sneezing will produce pain. I slept on a water bed and getting up out of bed was extremely difficult. I never used pain meds after surgery because I have a high pain tolerance. Things should improve after you get off the blood thinners - at least the bruises will start to fade slowly. On my discharge instructions identifying when to call your physician, many areas dealt with pain. For example: Uncontrolled or increased abdomen pain. Chest pain, rapid heartbeat and/or dizziness. Changes to your incision - new pain, swelling, redness, cloudy drainage.

This problems was discussed before. https://www.bariatricpal.com/topic/400104-coughing-up-blood/ https://www.bariatricpal.com/topic/372538-throwing-up-blood-5-weeks-post-op/ http://www.obesityhelp.com/forums/vsg/4227915/Back-home-2-5-days-out-questions-coughing-mucus Since coughing up blood is one of the signs of blood clots in the lungs (pulmonary embolism), I would probably err on the side of caution and let your surgeon's office know about this.

The knot under the main incision site is the last to heal. I am almost 5 years out now and it is completely gone. Even after a couple years, I was wondering if it would ever go away.

Welcome and let us know if we can be of any help. Attending local support group meeting can be good, they are areas where information can be exchanged and encouragement. But they can also provide the opposite. My insurance required that I attend support group meetings each month during pre-op. Many of those in attendance were pre-op. After surgery there was not really an attendance requirement, so many that attended post-op either attended because they wanted to give back to the community or because they had problems and then problems on top of problems and were seeking help. This gave a distorted view of the effects of surgery. Many individuals that had good outcomes from surgery just disappeared from the meetings. I put some of my experience after surgery in the following article and it may be of help. http://www.breadandbutterscience.com/Surgery.pdf At your stage 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.

The flu bug is suppose to be pretty bad this year. General advise for the flu is: * Rest until the flu is fully resolved, especially if the illness has been severe. * Fluids – Drink enough fluids so that you do not become dehydrated. One way to judge if you are drinking enough is to look at the color of your urine. Normally, urine should be light yellow to nearly colorless. If you are drinking enough, you should pass urine every three to five hours. * I would also recommend consuming chicken broth soup. According to the internet: According to the National Institutes of Health, the idea of hot soup as a cold remedy has been around since at least the 12th century and may really help ease the symptoms. All liquid broth soups will speed up the movement of mucous in your nose simply because it's a hot fluid and that causes dilation of blood vessels which causes increased blood flow and allows the mucous to flush everything out. And that will help alleviate congestion. Soups are also hydrating, which is particularly important when fighting off an infection. Clear broth soups are hydrating because they typically contain not only water but also salt and so those two together are good properties for hydration". * Avoid NSAIDs such as aspirin because it can lead to ulcers. * Use herbal teas designed to treat colds and flu. * You might consider using essential oils. These are applied topically on your wrist. I have been experimenting with essential oils for a few years. I developed a formula that I called the Superman oil, primarily for my grandkids to help them from contracting the flu or colds or other bugs. It uses over 21 essential oils. It is very effective and I use it on myself. It is also very effective at treating the flu. Whereas in years past when I contracted the flu, it would work its way slowly down into my lungs over several months and eventually develop into bronchitis. With this formula, it is gone in a couple days. So you might purchase an essential oil blend targeting the flu and try it.

One danger of surgery is the development of blood clots. According to the internet: Deep vein thrombosis (DVT) occurs when a blood clotforms in one of the deep veins of your body, usually in your legs, but sometimes in your arm. The signs and symptoms of a DVT include: Swelling, usually in one leg (or arm) Legpain or tenderness often described as a cramp or Charley horse. Shortness of breath, chest pain (particularly with deep breathing), coughing up blood, persistent leg pain, or redness, swelling, or warmth in your lower legs (usually one-sided) can all be indications of a blood clot in the legs or lungs, and should never be ignored. And, give yourself a break already. According to my discharge instructions, one of the times to call your surgeon's office was if you were experiencing chest pain. So although this might turn out to be nothing, I would take a cautious approach and keep your surgeon informed.

Congratulations.

Congratulations.

Congratulations.

It is common to do a little experimentation after surgery. That is how we learn. Some people can tolerate anything after surgery while others have problems and can tolerate very little. Weight loss is achieved during the short weight loss phase through meal volume control. The two operative words here are short and volume. So if you want to maximize your weight loss during this phase, you need to adhere to the program guidelines. I had RNY gastric bypass surgery and slid into the maintenance phase at 7 months. Sleeve patients lose weight at a much slower rate but can achieve almost the same degree of weight loss. Many do not transition into the maintenance phase until a couple years post-op. In general, there are two phases to weight loss. These are the weight loss phase and the maintenance phase. But there is another phase beyond the maintenance phase. This can occur around year 4. In this third phase the body becomes more efficient. Even if you follow a very regimented routine for diet, where your weight was very stable for a year, suddenly the weight begins to come back. If you are not very, very careful in this third phase, one might see major weight gain.

It sounds like you already know what to say to the girls. Just tell them your story - the good and the bad.

Every day things will improve. But it doesn't happen overnight. I took me 6 months until I reached my happy state when all the problems seemed to melt away.

As I neared the end of my weight loss phase as I transitioned into the maintenance phase, I found constipation became a major issue. I became so constipated that I had to rely on glycerin suppositories (that I had to shove up my rear end every few days) to unbind me. Eventually I found a cure that worked for me. I found that if I ate an apple each night before bedtime, by morning things were good. But it was important to eat the skin of the apple in addition to the pulp of the apple. Other past recommendations from this site to deal with constipation were: Smooth Move Herbal Tea Prune Juice (warmed) Prunes (4 in the morning and 4 at night) Magnesium citrate Insoluble fibers (Garden of Life Raw Fiber or Renew Life Triple Fiber). Haribo Sugar Free Gummy Bears [Warning: eating too many can cause severe diarrhea] Aerobic Magnesium 07 Ground Flax Seeds (but don’t try to grind it yourself). Use 2 tablespoons per glass of water every night before going to bed. Bowel Clear (herbal blend)

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 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.

I strictly avoid processed sugars. I have a sweet tooth and that is one of the major causes that contributed to my weight gain over my lifetime. I limit myself to artificial sweeteners (such as Splenda and sugar alcohols), to natural low calorie sweeteners (such as Stevia) and to the natural sugars found in fruits and milk. I had diabetes. That went into remission when I left the hospital two days after surgery and I have not taken any diabetic medicine ever since and my blood sugar levels are good. I am almost 5 years post-op RNY gastric bypass surgery. I test my blood sugar levels periodically. I read the labels of all food that I consume. I look at the grams of sugar per serving. If it is above 5 grams, I look at the ingredients. The ingredients are listed in order by highest percentage, and if the first 5 ingredients contain processed sugar (in any of its many forms), then I avoid this food, like a plague.

The pain goes away over time. I am almost 5 years post-op RNY gastric bypass surgery. I found gel pillows help, especially when I am driving long distances.

The kitchen utensil I found most useful was a full set of measuring cups. Many sizes were difficult to find. I also bought a small metal spoon. This was much more sturdier than the one given to me at the hospital. I also used a Ninja single serving cup blender to mix my protein shakes. It worked very well and allowed me to mix and drink using a sip cup head without changing cups.