James Marusek

I used Muscle Milk Light (Vanilla Creme) protein powder blended with water and a half a banana.

It is not normal for your weight loss to come to a prolonged dead stop after the 3rd week. So you will need to investigate the cause. What type of surgery did you have? I had RNY gastric bypass and did not encounter a stall that lasted more than a couple days during the beginning. Sleeve patients tend to encounter more stalls and their stalls last longer. So you might consult your surgeon's office about this. The three most important elements after RNY gastric bypass 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. Weight loss is achieved after surgery through meal volume control. You begin at 2 ounces (1/4 cup) per meal and gradually over the next year and a half increase the volume to 1 cup per meal. 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.

After returning from the hospital, many people find it difficult to sleep. Some people will sleep on a recliner for a few days. But don't do what I did - which was try to sleep on a water bed. Every time I tried to get up, it was instant pain. As you get further along and the fat disappears between you knees, it can be very difficult to sleep on your side because you can feel your bones rubbing together. I found that sticking a pillow between my legs at night help this immensely.

Body fat has a lot of thermal insulation. As you lose the fat, you will become more sensitive to the cold. I use to drive in the winter snow with my windows down because I was too hot. Now I shiver even if the windows are up and the heater on high. It does not get better, just learn to compensate for the cold. I am 4 1/2 years post-op. The individual that invented hand warmers should be given a medal. They really come in handy when I am shoveling snow in the winter.

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

Here are a few potential causes. 1. If you were diabetic prior to surgery and on meds, you may have to reduce your meds at this point. 2. You may be experiencing reactive hypoglycemia. Here are a few links that might help. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/ http://www.todaysdietitian.com/newarchives/060415p48tip.shtml https://www.healthline.com/health/hypoglycemia-without-diabetes 3. Dehydration can also cause dizziness and lightheadedness. https://www.emedicinehealth.com/dehydration_in_adults/page3_em.htm

Walking really helped me with the gas pain.

Congratulations.

Generally the 6 month supervised diet requirement comes from the health insurance companies. If you were on a medically supervised exercise and weight loss regiment for six months prior to surgery through you primary care physician and if that physician would be willing to write a letter documenting you attempt, that might count. But generally that meant you paid visits to your doctors office once per month for each of those six months in order to qualify. In terms of recommending a hospital, I had surgery at a Center of Excellence for Bariatric Surgery. These Centers of Excellence are available in many states. 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. Also back to insurance issues. For me the pre-op stage took around 9 months. Since most health insurance policies require a deductible. There is a good chance that the pre-op stage may stretch over two calendar years and therefore two deductible periods.

I had around 6 incisions after surgery. One in particular took a long time to heal, around a year. I asked the nurse about it and she said it is normal, that incision was the one through which most of the surgery took place.

Generally when I had my surgery, I gained several pounds when I was in the hospital because they pumped my body full of fluids. It took several days before I lost that weight and arrived at my pre-surgery weight. So please do not panic at this stage. Just keep following all the rules and you should see the pounds begin to fall off sharply. It is important to walk every day for around a half hour during the first year post-op. Also some people get so wrapped up in watching the scale that it stunts their weight loss because it totally stresses them out. To correct this problem, some individuals simple chose do not to weigh themselves and rather use the weight from their visit to the surgeon's office. So if stress is a major factor, then relax and consider alternatives to relieving the stress. My primary goal in getting gastric bypass surgery was to correct my severe health conditions. I had high blood pressure and diabetes and a host of other adverse health issues. Most of these were solved in the first couple weeks. I am around 4 1/2 years post op at this point and they remain in remission. So generally I met my primary goal almost immediately. Everything else was gravy. I measures success after this in terms of pounds lost, in reduced waist sizes and the ability to fit into smaller clothes, and also into non-scale victories (NSV's). As an example of an NSV, I had bought a beautiful Mazda Miata convertible when I retired but I had gained so much weight that I could hardly get inside it unless I had the top down. Now it fits like a glove.

I found that slipping a pillow between my legs help with sleeping. This becomes especially true as you lose fat around your knees and it begins to feel like you are rubbing two bones together. I bought a gel cushion to sit on. That helped. There are specially designed cushions that can help. Normally this became a problem when I went on long trips in the car, it became almost unbearable. The three most important elements after RNY gastric bypass 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. Weight loss is achieved after surgery through meal volume control. You begin at 2 ounces (1/4 cup) per meal and gradually over the next year and a half increase the volume to 1 cup per meal. 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. As far as the inability to meet your fluid goals. 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. As far as not being able to get your protein in: 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 would recommend that you keep experimenting until you find one that you can tolerate. You don't have to like it, just tolerate it. 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. Also it is common for individuals to be unable to meet their protein and fluid daily requirements from the get go. This is because their body is in a major heal mode. Just keep working towards the goals and you should be able to get there. Normally this is achieved after the first few weeks. As far as a lack of energy, this may point to a lack of fluids or protein but also perhaps vitamins. I do not know why your surgeon recommended no vitamins until after the first month. I can understand perhaps not taking B12 because you probably received a B12 shot in the hospital and that will cover you for the first month. But no vitamins sounds like strange advise. I think at a minimum you should be on a good multivitamin. I recommend that you verify this directive with your surgeons office. I wrote down my experiences with RNY gastric bypass surgery and here is a link to the article. It may be of some help. http://www.breadandbutterscience.com/Surgery.pdf

Congratulations.

Congratulations and good luck on your surgery. If you haven't already done so, I would recommend three things at this point. 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.

Sometimes the inability to pass gas can be a problem. A quick search of the internet provides the following: http://www.obesityhelp.com/forums/rny/4511526/Passing-gas-and-BM-after-surgery/ http://www.thinnertimesforum.com/topic/41895-unable-to-pass-gas-or-stool-after-surgery/ https://www.bariatricpal.com/topic/191058-3-days-post-op-gas/ https://www.gastricsleeve.com/forum/showthread.php?t=15517 On the last thread someone recommended deep breathing exercise by using the spirometer frequently.

For me the gas pain was generally resolved in the first few days. Right after surgery, I became lactose intolerant. So whenever I drank milk or other products with lactose, it lead to bloating and was quickly followed by diarrhea. So I went off all lactose for a couple months and then my body returned to normal. Some protein shakes contain lactose. Also, while you were in the hospital, most patients are given antibiotics as a general caution against infections. Antibiotics kill not only the bad bacteria but also the good bacteria in the gut. Therefore it is important that once you cease these antibiotics to restore this good gut bacteria by taking probiotics. According to the internet: People who are lactose intolerant may develop symptoms from using a probiotic supplement. Some probiotics contain from milk, which can trigger bloating, gas and diarrhea within a few minutes after ingesting the supplement.

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. 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.

Congratulations on your surgery, I hope your recovery goes smoothly.

Generally if it is gas pain, it should be easing up significantly at 8 days post-op. I found walking really helped to control this pain. I didn't understand the term "bisy" so maybe you could be more specific. An internet search only showed the abbreviation for Biomonitoring Information System for the Yukon

According to my surgeon's directions after my RNY gastric bypass surgery, I was on full liquids for the first four weeks, pureed foods for the next four and then finally in week 9, I was approved for solids. So my advise is that there is no need to rush these transitions. Your stomach needs time to heal. The transition to solids is the hardest transition of all three, so ease into it.

Another benefit of Bariatric Surgery. A new Centers for Disease Control and Prevention (CDC) report shows that 40 percent of all U.S. cancer diagnoses can now be linked to overweight and obesity. Out of all cancer diagnoses, nearly 55 percent of female cases and 24 percent of male cases were linked to overweight and obesity. These cases statistically affect older adults, mostly between the ages of 50 and 74-years-old. http://www.foxnews.com/health/2017/10/04/cdc-40-percent-cancers-linked-to-obesity-overweight.html

I think dealing with the health insurance company was the greatest pain I experienced during the process. More than the surgery itself. Good luck and just keep focused on your end goal.

Thanks for the information. I am sure the members of the website will want to know. If there is anything else you wish to share, please feel free to add additional information.

Everyone is entitled to a pet peeve.

I had RNY gastric bypass surgery over 4 years ago. This process has been around a long time and has a proven track record. Therefore it is almost a gold standard in gastric bypass surgery. Endoscopic sleeve gastroplasty (ESG) is rather an experimental process at this time and I have very little knowledge of this procedure. I keep getting it confused with Vertical Sleeve Gastrectomy (VSG) which has been around for awhile and is commonly called Sleeve surgery. Generally speaking if you have severe acid reflux (GERD) Sleeve surgery will only make the condition worse. I do not know about ESG surgery.