James Marusek

Good luck on your upcoming surgery and remember to have a good photograph of yourself prior to surgery, so that you have something to compare it with 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.

Congratulations.

Gas pains generally go away in about a week. You will still pass gas at a more frequent rate than pre-surgery, but it will not be painful, just socially unacceptable. Your former stomach was large and stored a lot of gas, your new stomach is smaller and is less able to do so. Remember walking goes a long way towards relieving gas pain. If you don't have a bowel movement during the first week don't be too concerned. Liquids in = liquids out.

I take Citrical for my calcium supplement, primarily because I buy it at Sam's club when it is on sale and it is fairly inexpensive. It was rough at the beginning because after surgery, I could not swallow it and I had to crush it. It took around 2 months before I could swallow that large pill again. Crushed Citrical taste like chalk and the only way I was able to get it to go down was mixing it in a glass of Crystal Light.

Good luck on your surgery. I will pray for you.

I always thought of my weight loss in terms of pounds of butter. It was easy to conceptualize my weight loss in this manner.

After surgery it took around 6 months before I reached a happy state, when all the problems seemed to melt away. Each day gets better but it does not happen overnight. Also beware that as fat cells dissolve away, they release chemicals and hormones that are store there. The release of these hormones can produce an emotional flush. So remember that fluids are used by your body to flush away these hormones and chemicals, so meeting the daily fluid requirements is important.

I have heard a few other individuals on this board complain about the fact that during the 6 month diet and exercise pre-op qualification phase, that the medical visits must be 6 consecutive months and that you could not miss one otherwise you get sent back to the end of the line. So it sounds like you are trying to warn Newbies to beware of this requirements. Anyways good luck on your surgery. At your stage I would recommend 3 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. Also if you haven't started to attend monthly Bariatric Surgery Support Group meetings, it is a good time to start. Everyone has questions and this is a meeting where people at various stages get to meet and discuss.

Many individuals find it difficult to meet their protein and fluid daily requirement during the first two weeks after surgery. You stomach is in a major heal mode. Just keep trying to work towards that goal each day and you should be able to get there.

You taste buds may change after surgery, so it may best to delay the down select until after surgery. Just be willing to experiment until you find something that works for you, You do not have to like protein shakes only tolerate them. There are many varieties of protein shakes available today. 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.

Generally sleep apnea is considered a comorbidity. My insurance policy reads 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: • T ype 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.

There are two stages to weight loss surgery - weight loss phase and the maintenance phase. The strategy for each phase is different. The following short article describes my experience with the maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

Congratulations.

Sorry to hear you are having difficulties. You said "I passed out at home after severe vomiting." That is an abnormal condition. When you went to the ER did they correct the problem? 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. So those three elements are what you should focus on. Many people find it difficult to meet their daily goals for protein and fluids from the get go. Just keep trying to meet these goals each day and you should be able to get there in a couple weeks. In terms of fluid requirements - 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 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 (like swimming pool water) 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.

After RNY surgery, you are required to take many vitamins for the rest of your life. This is because you body no longer synthesizes vitamins from food. That part of your stomach has been cut away, so this daily requirement is extremely important. Vitamin chemistry is important for absorption. Calcium supplements should be calcium citrate. There are also different chemistries of B12. I use the sublingual B12 and was told to use methylcobalamin. You cannot use a time-release version of B12. If you are taking iron supplements, it must be ferrous sulfate for the best absorption. Gummy vitamins are not absorbed properly and should be avoided. It is important to put a 2 hour separation between the vitamins that contain iron and those that contain calcium. So in my case I found that what works best for me is to take the iron supplements just before bedtime. I put my vitamins in a weekly pill container. I have one container for the morning and one for the night. And I use a very small glass bowl for my calcium supplements. I put my calciums in the bowl in the morning and take them throughout the day. If I am up and about I put my calciums in a ziplock bag and carry them with me.

I bought some baby food in preparation for my surgery, but I never used it. My taste buds changed too much to use it. If you go this route, remember to look at the label and avoid baby food with added sugar. According to the internet "Of the 79 infant mixed grains and fruits, almost half, 41, contained one added sugar; 35 of these had 35 percent of their calories coming from sugar." https://www.today.com/parents/packaged-food-babies-toddlers-loaded-sugar-salt-t14121

Before surgery I tried to get prepared by buying some foods such as baby food and chicken broth. I landed up not using it and it went to waste. This was because of two reasons. My taste buds changed significantly after surgery and I could not tolerate those foods. And secondarily, after surgery the amount of food I was eating was incredibly small. During the first 8 weeks, my meal volume was 2 ounces (4 tablespoons) per meal. Take out a 1/4 cup measuring cup and look at how small that is. That is the meal volume. Prior to surgery I was constantly hungry. Even when I was eating a meal, all I could think about was what I would eat for my next meal. After surgery (when I reached the solid food stage), I completely lost my hunger. So it was not difficult to lose the weight when I was not hungry. 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. So it might be unwise to be too prepared. The key is to experiment after surgery. Since your taste buds may change, experiment with the various formulations of protein shakes. You do not have to like protein shakes but you must be able to tolerate them until your meal volume rises to the point that you can met your protein requirements by food alone. Sometimes you can buy a variety pack of protein mixes at GNC. Also be willing to experiment after surgery to find fluids that you can tolerate. When I was in the hospital right after surgery, I couldn't even drink the water because it tasted overly chlorinated like swimming pool water.

arcwls said, "I’m finding it difficult being 4 days Post Op to even get 200mL (7oz) in!" Your body is in a major heal mode right after surgery. Many people find it difficult to meet their protein and fluid requirements during the first couple weeks. Just keep trying and you should be able to get there soon. Amburmist said, "Hi guys. Im about 2 months post op from gastric bypass and finding it SO difficult to get in my daily Water requirements (64oz min)." My discharge directions read "Drink 64-80 ounces of water or a low calorie liquid daily. This includes any protein supplement in liquid form." Since I was drinking 3 protein drinks (48 ounces of water) each day, it was not difficult to reach this goal. Amburmist said, "To make it even harder, my team says I have to drink a minimim of 64oz of water daily, and I'm not allowed to subtract any other liquids I have during the day (like Protein Shake or coffee or whatever) from the 64oz minimum water requirement." From my perception after talking with my nutritionist - 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 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.

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

Generally as you get closer, the surgeon's office should offer a class that provides detailed directions for the surgery and post-op. I would also recommend finding the nearest Bariatric Surgery Support Group meeting to your local and begin attending these. They should be free.

Not everyone experiences hair loss. I didn't. And many people who do experience loss recover their hair after they enter the maintenance phase. So it is a temporary loss. Since you are at the beginning of this process, 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.

I would recommend a good before photograph so that you have something to compare it with after surgery. I would not recommend an underwear photo because you may be tempted to share it with someone. I would recommend a bathing suit photo. 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. In my case I was the photographer in the family and as a result I rarely appeared in photographs. Also when I looked in the mirror, all I could see is a front shot, so I didn't really see the extent of my obesity. When I took my before photo, I used the time release function on the camera and took poses in several positions (front, back, right side, left side). This allowed me to recreate the same exact pose 6 months after surgery. This is the result.

There are two phases to weight loss surgery - the Weight Loss Phase and the Maintenance phase. The strategies for each phase is different. This is the approach I used in the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf It is common to have some limited weight gain after gastric bypass surgery. They call it a 20 pound bounce. The important thing is not let go beyond it. According to my nutritionist, meals (at one year post op and beyond) should consist of equal parts of protein, fats and carbs after the first couple years post-op. Snacks should be limited to primarily whole food options: nuts, natural nut butters, fruits, veggies, boiled eggs, string cheese, yogurt with berries and almonds, tuna pouches. Avoid processed packaged foods as much as possible. Before surgery, I had constant hunger. When I was eating a meal, my mind was thinking what I would have for my next meal. It was incessant. Now the interesting thing that occurred after my RNY surgery was that I completely lost my hunger. It was not difficult to plan my minuscule meals because I wasn't really hungry. This condition does not last forever but for about a year and then the hunger returns. It just isn't as strong as before. I also had a sweet tooth before surgery. Chocolate by itself isn't the primary problem but the sugar is. During the winter I normally drink a cup of hot cocoa. But it must be the No Sugar Added variety. Also Adkins makes a number of chocolate treats that contain artifical sweeteners that might satisfy your sweet tooth.

The primary component of Bio-Oil is PurCellin Oil, a synthetic version of the preen oil which is secreted by ducks. This oil helps duck feathers become waterproof. The oil acts as an effective delivery system for the product’s other ingredients speeding up absorption and improving spreadability. Bio-Oil also contains Vitamin A, Vitamin E, Lavender, Calendula, Rosemary oil and Chamomile.

After surgery your stomach is a lot smaller than when you went into the hospital. Normally your stomach has a lot of air. Sometimes if you have too much you will feel gas pains and bulch. But after surgery there is no place to store this air. Sipping through a straw only makes the problem worse.