James Marusek

Research studies show that mortality rates are higher for those that are obese along with those that are underweight. It is important to have a little fat on the body because when major injury or illness strikes, this fat is the reservoir of energy that the body draws on until recovery. So the end goal is to maintain a normal healthy body weight. I set my goal weight to the high side of normal BMI.

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. Many have an free introductory meeting that describes the various surgery options. Generally the decision of the type of surgery is made by you and the surgeon. There are medical reasons to chose one type over another. Such as if you have severe acid reflux (GERD) you would want to chose RNY gastric bypass over the sleeve because the sleeve will only make the condition worse.

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

There were several individuals on this website that had this condition, didn't know it and after surgery discovered that they had extreme nausea, which prevented them from eating. Probably the reason why you are taking two antibiotics at once is because using a single antibiotic has not treated the condition for individuals trying to kill this infection. Here are some links to a discussion on this topic. http://www.obesityhelp.com/forums/rny/4347753/SURGERY-WITH-H-PYLORI https://www.bariatricpal.com/topic/215679-h-pylori/ https://www.bariatricpal.com/topic/266403-stomach-h-pylori-bacteria/

Your body weight will fluctuate by several pounds on a daily basis. Many things can cause this fluctuation such as water weight gain, the clothes you wear, the time of day. Generally I weigh myself first thing in the morning, butt naked before breakfast. This tends to be my lowest weight. My clothes, coats and shoes can add 5 pounds to my weight. So generally the weight at the doctor's office is higher. The problem may also be due to your scale. After I had surgery, my scale was giving me all types of bad readings. I would step on the scale and weight myself and then repeat a couple seconds later and get a totally different reading, sometime a 5 pound difference. So I replaced my scale with one that was accurate to 0.2 pounds, repeatable readings, and a large visible backlit digital reading. I am half blind and since I weigh myself with my glasses off, it was difficult to step off the scale and bend down and read the results before the scale went off. Some digital scales will give erratic readings when the batteries are low.

Good luck on your surgery and when you get back from the operation, remember to walk, walk, walk while you are in the hospital. It will help with minimizing the gas pains.

H pylori is an infection that is treated by using antibiotics. H. pylori infections are usually treated with at least two different antibiotics at once, to help prevent the bacteria from developing a resistance to one particular antibiotic. Your doctor also will prescribe or recommend an acid-suppressing drug, to help your stomach lining heal. http://www.mayoclinic.org/diseases-conditions/h-pylori/diagnosis-treatment/treatment/txc-20318868 That is why you were prescribed two antibiotics amoxoclin and Biaxin. You definitely want to kill this infection prior to surgery. Otherwise after surgery you will experience extreme nausea and be unable to keep anything down. So do try and cheat this test, just make sure you kill the infection.

Good luck on your surgery. And remember to 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. Also after surgery remember to walk, walk, walk while you are in the hospital.

When I had surgery 4 years ago, my surgeon recommended 3 Flintstone complete chewable multivitamins daily. Since at the time these vitamins were readily available in large bottles at Sam's club, that is what I went with. But Sam's club has transitioned to gummy Flintstones which cannot be used for gastric bypass patients. The chewable are still available in small bottles at drug stores but they cost more. But they are still available in large bottles on-line at Amazon.

After RNY gastric bypass surgery, the part of your stomach that normally processes fats and sugars has been cut away and therefore if you consume these, they may lead to dumping. But after about a year, your body changes. The intestines figure out that the stomach is no longer processing these so they adjust and begin processing fats and sugars. At that point after about a year, it is possible to eat fats and sugars. After gastric bypass, I completely lost my hunger. So it was not difficult for me to drop the pounds after surgery because I was no longer 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. This lack of hunger does not last forever. It comes back after about a year but it is not as strong as pre-surgery. Not everyone experiences this phenomena but most do. This effect is not noticeable until one transitions from the full liquid stage and puree stage and advances into the solid food stage. So weight loss after surgery is very different than dieting. 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. 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. After around the first year after gastric bypass surgery, the weight has been lost and one transitions quite naturally from the weight loss phase into the maintenance phase. At this point hunger returns and the process of maintaining is similar to dieting. The goal here is to maintain the weight loss not necessarily to lose any more weight. Since hunger has returned, it is very important to control the hunger. Fats help to take away hunger. And at this stage, your body can consume fats. So it is important at this stage to begin to include fats back into your diet. So after about a year or two post-op, my nutritionist recommends that meals contain an equal amount of protein, fat and carbs, but always put protein first.

After bariatric surgery, some people experience a stricture. This can cause the condition you described. According to the internet: Strictures can occur once you are about 4 to 8 weeks out from surgery. A stricture is a narrowing of the new stomach outlet where it surgically attached to the small bowel. Symptoms include difficulty with eating solid foods, developing increased saliva or mucous, reflux symptoms, and in severe cases, difficulty with liquids. A stricture, with time, can resolve on its own, but often the waiting time to heal can make you feel miserable. Once you are out at least 4 weeks from surgery, balloon dilation with endoscopy can be performed to open up the narrowing. Several balloon dilations might be needed to fix the issue.

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. Some places such as GNC sell small sample packs so you can try them out individually before you commit.

One month out wounds should heal. There might be an underlying condition such as diabetes that might be interfering with wound healing.

I had RNY gastric bypass surgery over 4 years ago. I did this primarily for many health issues that were creeping up on me including high blood pressure, diabetes, GERD and sleep apnea. These conditions went into remission within a few weeks after surgery. One of the reasons why I choose RNY was because I had severe acid reflux. One of the individuals in our bariatric surgery support group meeting had the band but after several years, the band started to erode into his stomach and it became a life threatening condition. So he had it removed and replaced with gastric bypass. He was pleased with he results. The only thing in his case was that the band had created a lot of scar tissue and when they revised him to RNY his pouch was a little smaller than most. Therefore he adjusted by having smaller meals but increased the number of meals to compensate. As far as taking vitamins for the rest of my life, that was a concern prior to surgery. But I am off all 4 prescription meds that I was taking prior to surgery. The cost of all my vitamins is cheaper than all my prescription meds. The only inconvenience is the time spacing. I tried B12 shots for a few months but I had my wife administer them to me in the arm. I noticed that she turned her head away just before she put the needle in my arm. She is afraid of blood. Therefore I stopped doing this and went with sublingual B12 daily. These tablets actually taste good and are enjoyable to take.

Prior to surgery, I was on two types of prescription medicine to control my high blood pressure. I had been on the meds for several years. I tested my blood pressure each day and tracked it. After surgery I noticed that my blood pressure was dropping so I reduced my meds and then at the end of 2 weeks I went completely off my meds for this condition. My high blood pressure went into remission and has remained there. I am over 4 years post op RNY gastric bypass surgery. So consult your doctor about reducing you medicine. The only reason why I did it on my own was because I tracked my blood pressure daily and I felt confident in making that decision myself.

According to the internet: Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and noncompliance with a gastroplasty diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%. Although no unifying explanation for the etiology of anastomotic ulcers exists, most experts agree that the pathogenesis is likely multifactorial. These ulcers are thought to be due to a combination of preserved acid secretion in the pouch, tension from the Roux limb, ischemia from the operation, nonsteroidal anti-inflammatory drug (NSAID) use, and perhaps Helicobacter pylori infection. Evidence suggests that little acid is secreted in the gastric bypass pouch; however, staple line dehiscence may lead to excessive acid bathing of the anastomosis. Treatment for both marginal ulcers and stomal ulcers should include avoidance of NSAIDs, antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition, H pylori infection should be identified and treated, if present. So the general advice from above if I am interpreting it properly is to eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed. Also avoid NSAIDs (such as Aspirin, Ibuprofen, Diclofenac, Naproxen, Meloxicam, Celecoxib, Indomethacin, Ketorolac, Ketoprofen, Nimesulide, Piroxicam, Etoricoxib, Mefenamic acid, Carprofen, Aspirin/paracetamol/caffeine, Etodolac, Loxoprofen, Nabumetone, Flurbiprofen, Salicylic acid, Aceclofenac, Sulindac, Phenylbutazone, Dexketoprofen, Lornoxicam, Tenoxicam, Diflunisal, Diclofenac/Misoprostol, Flunixin, Benzydamine, Valdecoxib, Oxaprozin, Nepafenac, Etofenamate, Ethenzamide, Naproxen sodium, Dexibuprofen, Diclofenac sodium, Bromfenac, Diclofenac potassium, Fenoprofen, Tolfenamic acid, Tolmetin, Tiaprofenic acid, Lumiracoxib, Phenazone, Salsalate, Felbinac, Hydrocodone/ibuprofen, Fenbufen]. Most forms of Excedrin contains aspirin. Use proton pump inhibitors [Omeprazole, Pantoprazole, Esomeprazole, Lansoprazole, Rabeprazole, Dexlansoprazole, Rabeprazole sodium, Pantoprazole sodium, Esomeprazole magnesium, Omeprazole magnesium, Naproxen/Esomeprazole, Esomeprazole sodium, Omeprazole/Bicarbonate ion] and/or sucralfate [Carafate] antacid. And have yourself tested for Helicobacter pylori infection.

Good luck on your surgery. I will pray that it is successful. Remember to take a good before photograph 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. And after the surgery remember Walk, Walk, Walk.

The transition to solid foods such as chicken and steak can be rough. I found that softer foods such as high protein homemade chili and soups went down much easier than solid foods, so therefore I focused on these. I have included some recipes in the following article. http://www.breadandbutterscience.com/Surgery.pdf Anyways, there is no need to rush this transition, just take your time.

You can have decaf coffee soon after surgery. But you will probably want to wait a year before you get back on caffeine again. Caffeine may intellectually challenged your weight loss.

Good luck on your upcoming surgery. I would recommend three things to do if you haven't already done them. 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.

It seemed like when I was 1 year post-op, I experience a stomach virus. It went away rather quickly. I attribute this to the quantity of vitamins I had to take daily after my RNY gastric bypass surgery.

A very large international study, the Prospective Urban Rural Epidemiology (PURE) study included over 135,000 people from 18 countries in North and South America, Europe, Africa, and Asia. As is usually the case with this type of epidemiological study, various aspects of the results were reported and published separately, although the reports were based on the same data. One report on fruit, vegetable and legume intake and their association with cardiovascular disease (CVD) and death, was published in The Lancet, as was the second report, linking dietary nutrients, i.e. carbohydrates, proteins and fats, with those outcomes. The first report on fruit, veggie and legume (FVL) intake found an inverse association between higher intakes of those foods and major CVD endpoints such as heart attacks, major CVD, cardiovascular mortality and total mortality [death]. In the second study, data was analyzed to determine consumption levels of macro-nutrients — fat, protein and carbohydrates — and any association with CVD and mortality. Intakes of these nutrients were divided into 5 groups — quintiles — and the association between the levels of consumption and the risk of CVD and mortality was determined. The second report found: For carbohydrate consumption, they found a 28 percent significantly increased risk of total mortality for the highest quintile of consumers compared to the lowest Those in the highest quintile of consumption of total fat, saturated, unsaturated and polyunsaturated fats, compared to those in the lowest quintile, had lower risks of total mortality (anywhere from a decrease of 14 to 33 percent). In addition, a higher intake of saturated fat was associated with a 21 percent lower risk of stroke. https://www.acsh.org/news/2017/09/01/fruit-and-veggies-beneficial-heart-health-carbs-arent-what-11765

These are some of the common abbreviations used on this website: ACL = Anterior cruciate ligament AGB = Adjustable gastric banding AMRAP = As Many Rounds As Possible (crossfit) AT = Aspiration Therapy BB = belly button bc = because BCBS = Blue Cross/Blue Shield BED = Binge Eating Disorder bf = best friend BM = bowel movement BMI = Body Mass Index bp = blood pressure BPD = Borderline Personality Disorder or Biliary Pancreatic Diversion bs = blood sugar btw = by the way C25K = Couch Potato to Running 5K CBT = cognitive-behavioral therapy CC = common channel c diff = clostridium difficile cos or cuz = because CPAP = continuous positive airway pressure CRNP = certified registered nurse practitioners CT = Computed Tomography (commonly called CAT Scan) cw = current weight CXR = Chest X-Ray DDD = degenerative disc disease Dr. = doctor DS = Dumping Syndrome or Duodenal Switch EBT = Endoscopic Bariatric Therapies EGD = Esophagogastroduodenoscopy EKG = Electrocardiography ER = emergency room ESG = Endoscopic Sleeve Gastroplasty ff = fat free f/u = follow up GB = gastric bypass GERD = gastroesophageal reflux disease GI = gastrointestinal GIF = Gastric Intrinsic Factor GNC = General Nutrition Corporation store GP = general practitioner or family doctor HBP = high blood pressure hr = heart rate hw = highest weight ICU = Intensive Care Unit Idk = I don’t know IGB = intragastric balloons IF = Intrinsic Factor IMHO = in my humble (honest) opinion IMO = in my opinion IUI = Intrauterine insemination LAP Band = Laparoscopic Adjustable Gastric Band LES = lower esophageal sphincter lol = laughing out loud LSG = Laparoscopic Sleeve Gastrectomy med = medicine MFP = my fitness pal MGB = Mini Gastric Bypass msg = message NAFLD = nonalcoholic fatty liver disease NASH = Nonalcoholic steatohepatitis nf = non fat NG = Nasogastric NP = nurse practitioner NSAIDS = Non-steroidal anti-inflammatory drug NSV = non-Scale victory (“scale” means “weight scale”) NUT = nutritionist OA = Overeaters Anonymous omw = on my way Onederland = a magical place or destination for those trying to lose weight. It might correspond to attaining a weight in the hundreds or losing a hundred pounds. op = operation OSA = Obstructive Sleep Apnea OTC = Over the counter Oz = Australia PB = Productive Burps PCOS = Polycystic Ovary Syndrome PCP = Primary Care Physician PICC= Peripherally Inserted Central Catheter PM = private message (email) PMS = premenstrual syndrome POSE = Primary Obesity Surgery Endolumenal postop or post–op = post-operation or post-surgery PPI = Proton Pump Inhibitors ppl = people preop or pre-op = pre-operation or pre-surgery PTSD = Post-Traumatic Stress Disorder PVC = Premature ventricular contractions RA = Rheumatoid arthritis RH = reactive hypoglycemia RN = registered nurse RNY = Roux-en-Y RTD = ready to drink Rx = Prescription medicine RYGB = Roux-en-Y gastric bypass SADI-S = single anastomosis duodeno–ileal bypass with sleeve gastrectomy s/f or sf = sugar free SG = Sleeve gastrectomy SIPS = stomach intestinal pylorus-sparing surgery smh = shaking my head, scratching my head SO = significant other SOB = shortness of breath sw = weight at surgery tmi = too much information TPN = total parenteral nutrition TT = tummy tuck TTC = trying to conceive Ty = Thank you. [but according to the urban dictionary “Ty” is also an abbreviation for “a total stud with a massive carrot”.] u = You UGI = Upper Gastrointestinal VSG = Vertical Sleeve Gastrectomy Vit = vitamin wks = weeks WLS = Weight Loss Surgery WOD = Workout of the Day w/o = without wt = weight

Good luck on your surgery.

Good luck on your upcoming surgery. Since your surgery is on Wednesday, I would recommend 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.