James Marusek

Right after surgery your body is in a major heal mode. Many find it difficult to meet their fluid and protein goals right out of the gate, just keep trying and you should be able to get there after a couple weeks.

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.

This morning, I read a humorous article titled Man Boobs From Hoppy Beer? An 'Earth Poet' Says Yes, Science Says No. https://www.acsh.org/news/2017/11/01/man-boobs-hoppy-beer-earth-poet-says-yes-science-says-no-12061 But it does bring up an interesting topic. For several decades prior to my RNY gastric bypass surgery, I had enlarged breast. As a man this is rather embarrassing condition, especially when I go to the YMCA for a swim. According to this article When the enlarged breasts are a result of obesity it is called pseudogynecomastia. I am now over 4 years post-op and my breasts have returned closer to their normal size. Has anyone else noticed this effect?

This thread has nothing to do with weight loss surgery but it was interesting. I ponder a lot. One of several thousand things that I ponder over is the bubonic plague which also goes by the name the Black Death. This was a series of plagues that struck the world during the Middle Ages. The plague is believed to be the cause of the Black Death that swept through Asia, Europe, and Africa in the 14th century and killed an estimated 50 million people. This was about 25% to 60% of the European population. People were dropping like flies. It is commonly thought that the plague was transmitted by fleas that traveled with rats. But I think this may not be true. I suspect that the real transmission agent was man, specifically individuals infected with the plague that traveled across the world. So this morning I read an article about research from a group at Fordham University, published in Molecular Ecology, compared the genetic makeup of 262 brown rats (Rattus norvegicus) living in Manhattan. What they found was It is estimated that rats came to Manhattan between 1750-1770 on ships from Western Europe, particularly France and England. Despite NYC being the melting pot that it is, the DNA from rats of today still closely resembles their earliest European ancestors. What the analysis of the genetic diversity found is that rats don't move far from where they were born. Within the island, they found two main evolutionary clusters - uptown and downtown Manhattan. In addition, the rats stay even more local than that. It is rare that they even move off of their block. https://www.acsh.org/news/2017/12/07/nyc-rats-moving-fuhgeddaboudit-12252 So rats do not travel far from home but man does. And if this type of plague occurs again, it can travel across the world in a heartbeat because we travel by air, by sea and by land. So I ponder if the medical community will be up to the challenge. When I was young I was vaccinated against the bubonic plague. It was the worst shot I ever received. A hundred times more painful than the shot for small pox. The plague still exists in the world today and we know how to treat it. But I suspect if this plague ever rises again it will be a deadly genetic variant that the world must deal with.

Dizziness or light-headedness when standing up occurs as a result of abnormal blood pressure regulation. Normally, when people stand, gravity causes blood to pool in the veins of the legs and trunk. This pooling lowers the blood pressure and the amount of blood the heart pumps to the brain. According to the internet: When you stand up, gravity causes blood to pool in your legs and abdomen. This decreases blood pressure because there's less blood circulating back to your heart. Normally, special cells (baroreceptors) near your heart and neck arteries sense this lower blood pressure. The baroreceptors send signals to centers in your brain, which signals your heart to beat faster and pump more blood, which stabilizes blood pressure. These cells also narrow the blood vessels and increase blood pressure. Orthostatic hypotension occurs when something interrupts the body's natural process of counteracting low blood pressure. Many different conditions can cause orthostatic hypotension, including: Dehydration. Fever, vomiting, not drinking enough fluids, severe diarrhea and strenuous exercise with excessive sweating can all lead to dehydration, which decreases blood volume. Mild dehydration can cause symptoms of orthostatic hypotension, such as weakness, dizziness and fatigue. Heart problems. Some heart conditions that can lead to low blood pressure include extremely low heart rate (bradycardia), heart valve problems, heart attack and heart failure. These conditions prevent your body from responding rapidly enough to pump more blood when standing up. Endocrine problems. Thyroid conditions, adrenal insufficiency (Addison's disease) and low blood sugar (hypoglycemia) can cause orthostatic hypotension, as can diabetes — which can damage the nerves that help send signals regulating blood pressure. Nervous system disorders. Some nervous system disorders, such as Parkinson's disease, multiple system atrophy, Lewy body dementia, pure autonomic failure and amyloidosis, can disrupt your body's normal blood pressure regulation system. After eating meals. Some people experience low blood pressure after eating meals (postprandial hypotension). This condition is more common in older adults. There could be a few causes to review. The first is dehydration. Make sure you are meeting your fluid requirements. The second is an electrolyte imbalance. Are you taking the right mix of minerals in your daily vitamins and is the form of the vitamins, a type that can be absorbed by your new stomach. The third element has to do with prescription medicine. Prior to my surgery I had high blood pressure. Within weeks after surgery, I took myself off all my high blood pressure meds because my blood pressure returned to normal. If you were and still are taking prescription meds for high blood pressure, this may be a sign to talk to your doctor and reduce your medication.

Good luck on your surgery and remember after the operation when you return to your hospital bed to Walk, Walk, Walk.

Generally you are tested for sleep apnea because you have shown signs of having sleep apnea.

Congratulations.

I had RNY gastric bypass surgery. I think the total cost for the operation and all the preparatory work was around $50K. I found that getting qualified through my health insurance company gave me the most headaches for the entire process. I had the surgery done primarily to improve my health, weight loss was only a secondary consideration. I had high blood pressure, diabetes, sleep apnea, severe acid reflux (GERD) and a number of other issues. I was taking 4 types of prescription medicines and even those did not solve the problems. Within a few weeks after the operation I was off all my prescription meds. I am over 4 1/2 years post op. So the surgery met my expectation. It even helped solve my severe asthma problem. And I lost a lot of weight to boot. I dropped from a size 3X in shirts down to a size small and from a size 46 in pants down to a size 33. I replaced my whole wardrobe with the latest fashions. That was another win I didn't count on. It takes about a year for the scaring to disappear. I did not find the the loose skin was that much of a problem. It probably depends on your initial weight prior to surgery. Most of my family and friends were very supportive. But even if they were not I would still have gone this route. I go out to eat at restaurants. I eat a little bit of the meal and then take the rest home as left overs for 2 or 3 meals. You might look at the bright side and consider that you will have more time to talk during meals, more time to socialize.

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 good to be open to experimentation after surgery to find something that works for you.

I am over 4 1/2 years post-op RNY gastric bypass surgery. I am still the same me except I am a lot more healthy and able to do many more things.

I don't remember dry mouth being a problem when I was in the hospital. Perhaps it was because I was sucking on ice chips.

I didn't even know they had a spray. I just rinsed my mouth out with the mouth wash.

During the few days after surgery, many people find it difficult to sleep in their beds and instead sleep in a recliner or couch. Normally, I slept on my side but that was uncomfortable so I slept on my back for a few weeks. A few months after surgery, the fat disappeared around my knees. And when I slept on my side, I could feel my leg bones rubbing together. That was unnerving. I found that sliding a pillow between my legs at night helped.

Good luck on your surgery and remember after the operation while in the hospital to Walk, Walk, Walk.

Congratulations.

Congratulations.

Good luck on your surgery.

I used a Ninja blender and was pleased with it. It had a single serving cup, which meant I could blend my protein shake, change lids and drink my shake without pouring it into another glass.

Generally if you suffer from severe acid reflux (GERD), RNY gastric bypass is the best choice because the sleeve can make the condition worse. We had one individual in our bariatric surgery support group that had a revision from lap-band to gastric bypass. His band started to wear into his stomach and that was a life threatening condition so he had to have it removed. Generally speaking he was happy with the revision. In his case there was a lot of scar tissue because of the lap band, so when they did the revision, his pouch was smaller than most. This meant that the volume of food he could consume at any time was less than normal. He compensated by eating more meals per day and he was fine with that.

According to the internet: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. Treatment recommendations for NAFLD are aimed towards weight reduction, thereby reducing insulin resistance. Unfortunately, lifestyle modifications have not yielded long-term success, while durable weight loss is routinely achieved with bariatric surgery. https://www.medscape.com/viewarticle/763056 So what this summary says it that lifestyle modifications such as dieting and exercise have not yielded long-term success but bariatric surgery has. Another article says: Nonalcoholic fatty liver disease is a progressive disease with potential evolution to liver cirrhosis and hepatocellular carcinoma. Another article says: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. It encompasses a spectrum of conditions associated with lipid deposition in hepatocytes. It ranges from steatosis (simple fatty liver), to nonalcoholic steatohepatitis (NASH–fatty changes with inflammation and hepatocellular injury or fibrosis), to advanced fibrosis and cirrhosis. Studies suggest that although simple fatty liver is a benign condition, NASH can progress to fibrosis and lead to end-stage liver disease. The disease is mostly silent and is often discovered through incidentally elevated liver enzyme levels. It is strongly associated with obesity and insulin resistance and is currently considered by many as the hepatic component of the metabolic syndrome. NASH cirrhosis is now one of the leading indications for liver transplantation in the United States. I underwent RNY gastric bypass surgery because my health was deteriorating rapidly. I dieted and exercised and still could not shed the pounds but instead continued to gain the weight. I had the surgery to correct my health conditions. The surgery corrected a number of my health conditions including diabetes, high blood pressure, sleep apnea, acid reflux (GERD). It even corrected my asthma condition. If your focus is to become healthy and live a long productive life, then I would suggest the surgery. I dropped 120 pounds after surgery and my BMI went to normal. Weight loss was just a little gravy on top of health improvements. One of the factors that enter into the equation is cost. The operation is expensive and therefore it is important to have insurance that covers the operation. Therefore the guideline requirements from your insurance policy will dictate how easy it is to obtain this surgery. Many insurance policies are written very similar, so this will give you an idea: Surgical treatment of obesity (bariatric surgery) is covered only if: - eligible enrollee is 18 of age or over - clinical records support a body mass index of 40 or greater (or 35-40 when there is at least one co-morbidity related to obesity). Applicable co-morbid conditions include the following: * Type II diabetes mellitus (by American Diabetes Association diagnostic criteria). * Refractory hypertension (defined as blood pressure of 140 mmHg systolic and or 90 mmHg diastolic) despite medical treatment with maximal dose of three antihypertensive medications. * Refractory hyperlipidemia (acceptable levels of lipids unachievable with diet and maximum doses of lipid lowering medications). * Obesity–induced cardiomyopathy. * Clinically significant obstructive sleep apnea. * Severe arthropathy of the spine and or weight bearing joints (when obesity prohibits appropriate surgical management of joint dysfunction treatable but for obesity). - Documentation of failure to lower the body mass index within the last 12 months through a medically supervised program of diet and exercise of at least 6 months duration. So if your health insurance policy was similar to mine, you would not be able to qualify because of age; but the moment you turned 18, you would get a green light because your BMI is over 40. So the best advise I can give you is to dig out your health insurance policy and read the fine print.

I am not a doctor and I had a different weight loss surgery than lap-band. So take anything I say with a grain of salt. The fact that you are vomiting blood and when you drink water you vomit bile seems very abnormal and these problems must be driven to ground. Many years ago, one of my daughters woke up after vomiting a lot of blood. We rushed her to the emergency ward of the hospital. They said the cause was a nose bleed. When the air becomes extremely dry such as during the wintertime, the fine blood vessels in the nose can break producing a nose bleed. When she was sleeping the blood pooled in her stomach. When she woke up, she coughed blood and quite a bit of blood to clean her lungs. The solution in her case was to use vaseline and put a small coat inside her nose to coat the area with the fine blood vessels. In her case this worked quite well. My mother became anemic due to loss of blood which appeared in her stool. We took her to the hospital and they gave her a transfusion. In her case she used Excedrin as a pain reliever and would pop several pills a day for years. Excedrin contains aspirin and she was taking about 10 times the aspirin recommended. We took her off the over the counter medicine and her blood loss cleared up. According to the internet: Green or yellow vomit, also known as bile, is produced by the liver and stored in the gallbladder. The release of bile occurs when an individual is vomiting on an empty stomach or is suffering from bile reflux. Bile reflux may be caused by: Surgery complications. Gastric surgery, including total removal of the stomach (gastrectomy) and gastric bypass surgery for weight loss, is responsible for most bile reflux. Peptic ulcers. A peptic ulcer can block the pyloric valve so that it doesn't open enough to allow the stomach to empty as quickly as it should. Stagnant food in the stomach can lead to increased gastric pressure and allow bile and stomach acid to back up into the esophagus. Gallbladder surgery (cholecystectomy). People who have had their gallbladders removed have significantly more bile reflux than do people who haven't had this surgery. https://www.mayoclinic.org/diseases-conditions/bile-reflux/symptoms-causes/syc-20370115 Here are some other threads that might be of help. https://www.bariatricpal.com/topic/112336-bile-reflux-or-too-tight-of-restriction/ https://www.obesitycoverage.com/weight-loss-surgeries/lap-bands/lap-band-complications One other thought that crossed my mind is Helicobacter pylori infection. Many people have this infection and do not even know it. This infection can produce bile reflux. So if you haven't already been tested for this condition, it is probably worth doing. According to http://www.naturallivingcenter.net/ns/DisplayMonograph.asp?StoreID=B571DEWXVCS92JJ200AKHMCCQA7W8V75&DocID=condition-bilereflux Helicobacter pylori infection of the stomach: It has been reported that patients with esophageal bile reflux had a higher likelihood of also having Helicobacter pylori infection of the stomach than patients without bile reflux.

Good luck on your surgery. I will pray for you. Remember after the surgery while you are in the hospital to Walk, Walk, Walk.

Prior to my RNY gastric bypass surgery, I had sleep apnea. My wife is a light sleeper and my snoring would keep her awake all night long. This went on for years. Within a few weeks after surgery, this problem went into remission and has remained in remission ever since. I am over 4 1/2 years post-op. A few months after my operation, I would wake up in the middle of the night and find my wife hovering over me as I slept. I asked her what she was doing. She said I was sleeping so quietly, she was trying to tell if I was still alive.

I can sympathize. Your incision points are very painful when you cough. I did a quick search on the internet for natural cough suppressants. Here is a link. https://www.healthline.com/health/allergies/best-natural-cough-remedies In reading down the list I came across probiotics as one of the recommendations. While in the hospital, many patients are given antibiotics to kill any potential infections. The antibiotics will not only kill the bad bacteria but also the good bacteria in your gut. When you get home, it is important after surgery to take probiotics to restore these colonies of good gut bacteria. I have tried several other of these natural remedies over the years, and many have merit.