James Marusek

If you can sip down 1 cup of Water in about 20 min without any issues at all, then I would say all is good. Just follow your recommended daily fluid requirements. My surgeon recommended 65-80 ounces per day.

If this problem is associated with her operation, then I would focus on her daily vitamin requirements. After RNY gastric bypass surgery, the patient is required to take many vitamins for the rest of your life. This is because their bodies 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. The directions I received after surgery was: * Three Flintstone complete chewable multivitamins daily. * Additional 65 milligrams elemental iron daily for menstruating women. * 1500 to 1800 milligrams calcium citrate daily [this can be tricky because the dosage rate is per 2 capsules - therefore this can mean around 5-8 capsules per day depending on the size (petite or regular)]. * 500 to 1000 micrograms sublingual B12 daily or 1000 microgram injection once monthly. * 100 milligrams Thiamine (vitamin B1) daily for the first year and then weekly thereafter. A lack of vitamins can cause many serious problems, such as lack of energy and dental problems. Generally after gastric bypass surgery, the patient has an extensive blood work done. This should be done yearly. A quick check of her last blood test will tell you if this is the problem area.

According to the internet: If you shun the sun, suffer from milk allergies, or adhere to a strict vegan diet, you may be at risk for vitamin D deficiency. Known as the sunshine vitamin, vitamin D is produced by the body in response to skin being exposed to sunlight. It is also occurs naturally in a few foods -- including some fish, fish liver oils, and egg yolks -- and in fortified dairy and grain products. Vitamin D is essential for strong bones, because it helps the body use calcium from the diet. Traditionally, vitamin D deficiency has been associated with rickets, a disease in which the bone tissue doesn't properly mineralize, leading to soft bones and skeletal deformities. But increasingly, research is revealing the importance of vitamin D in protecting against a host of health problems.

You might try refocusing your snacks to healthy alternatives. You might consume 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. Try A tub of Dannon Oikos Triple Zero yogurt with about a quarter cup of fresh blueberries. It is also important to avoid all forms of processed sugars and remove them from your diet. I was diabetic prior to my RNY gastric bypass surgery and took two types of prescription medicine to control the condition. But even with that medication my diabetes was not being properly controlled. Two days after surgery when I left the hospital I was off all my prescription medicine for this condition and haven't taken any since. I am over 4 years post-op and text by blood sugar about once per month and it is fine. That is how quickly this condition can be corrected by surgery - almost overnight.

I was told by my surgeon to avoid gummy vitamins and time release vitamins because they would not be absorbed properly.

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. Some people report a lack of energy after surgery. You discussed a couple of the causes: not meeting your daily water intake and protein intake requirements. But it seems that you are meeting your goals here. Then you discussed taking your multivitamins and calciums. But there are other vitamin requirements that you did not mention that can also affect your energy levels. One of these is iron which can cause anemia. According to my discharge directions - menstruating women should add an additional 65 milligrams elemental iron daily. B12 is another vitamin that can affect energy levels. RNY gastric bypass patients should take 500 to 1000 micrograms sublingual B12 daily or 1000 mcg IM injection once monthly. Since you are 8 days post-op, I suspect they administered a B12 shot when you were in the hospital before discharge, so you should be covered for the first month. But it never hurts to ask. My surgeon also recommended 100 mg Thiamine (Vitamin B1) daily for one year following surgery and then weekly thereafter. Also if you have not taken probiotics to restore the lost colonies of good gut bacteria, that would be a good move.

I didn't experience any body dissociation after my RNY gastric bypass surgery. I remember right after surgery, it was extremely difficult integrating all the rules that I had to follow. With all the spacing between meals/liquids and vitamins, it seemed like one would need about a 36 hour day to accomplish. Luckily it got easier as I went along.

There are two phases to weight loss surgery - the Weight Loss Phase and the Maintenance phase. 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 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. Also do not expect to lose weight at a rate similar to right after surgery. There is no quick fix. Generally if you gained the additional weight over a couple years, then it may take a couple years of watching what you eat to get back down.

Congratulations.

I had RNY gastric bypass whereas you had the Duodenal Switch. But many of the main points apply to both types of procedures. The three most important elements after weight loss 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. 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 important to begin your day with breakfast. 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. 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. It might be a little too soon to transition to protein bars. It wasn't until the 3rd or 4th month that my nutritionist recommended them. Your stomach may still need a little extra time. A protein bar is probably too dense at this point. I used Quest protein bars. These bars were good in that they had high protein, minimal sugar and also contained fiber. They also came in a lot of different flavors. Protein bars are good when you are on the go and can't drag along a blender in order to mix a protein shake. A Quest protein bar contains 220 calories and provides 21 grams of protein. A Muscle Milk Light protein [2 scoops of powder in a 16 ounce glass] contains 210 calories and provides 25 grams of protein. So they are comparable. I found that softer foods such as chili and soups went down much easier than harder foods such as steak and chicken. So therefore I relied on these. I have included some recipes in the following article. Generally I make a pot and it last me for the entire week. http://www.breadandbutterscience.com/Surgery.pdf

Before my RNY gastric bypass surgery, I was a profuse sweater. I would take a few steps and beads of sweat would roll down my back and my face. When it was below freezing outside, I normally drove with the windows of my car open. My family members had to remember to bring along jackets or coats. This condition, profuse sweating, went on for many years - probably 20 years. Excessive sweating, or hyperhidrosis, can be a warning sign of thyroid problems, diabetes or infection. Excessive sweating is also more common in people who are overweight or out of shape. I had diabetes and was overweight. After surgery, that condition went into remission. I rarely sweat. And even though my breath odor is very bad, I think my body odor is less of a problem because of minimal sweating.

Those who underwent RNY gastric bypass surgery are required to 500-1000 micrograms (mug) of sublingual B12 daily or 1000 mcg IM injection monthly. Originally I thought the monthly shot would be easier even though it required a prescription and a trip to the drug store. But I had my wife give me these shots in my arm. I noticed she would always look away just before she inserted the needle in my arm. So I switched to the tablets. I use the sublingual B12 and was told to use methylcobalamin. You cannot use a time-release version of B12. They work fine and taste good.

After surgery, the odor of my breath changed. I didn't notice it but my wife sure did. She described it as the smell of death. As a result, she has me take breath mints before she let's me out in public.

Good luck on your surgery and let us know if we can be of any help.

Good luck on your surgery and let us know if we can be of any help.

There are two phases to weight loss surgery - the Weight Loss Phase and the Maintenance phase. Because you had surgery around 3 1/2 years ago you are most likely in the Maintenance phase. 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 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. Also do not expect to lose weight at a rate similar to right after surgery. Generally if you gained the additional weight over a couple years, then it may take a couple years of watching what you eat to get back down.

After I retired I decided to lose some weight by dieting. It didn't work instead I began gaining more weight. I decided to exercise so I joined a gym and gained more weight. I knew I was in trouble because my body had reached a point where even dieting and exercise did not cause weight loss. So I decided to have RNY gastric bypass surgery. That was over 4 years ago. That worked. 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 am over 4 years post-op RNY gastric bypass surgery and do not consider myself fat any longer.

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.

Chills and hot flashes are generally associated with an infection.

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.

Congratulations. 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.

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

What is a pescatarian? According to the internet, a pescatarian (or pescetarian) is a person who eats seafood but not other types of meat. Pescatarians are similar to vegetarians, but the difference is that pescatarians eat fish and shellfish in addition to an otherwise vegetarian diet.

According to my nutritionist after you enter the Maintenance phase, your meals should consist of equal parts of protein, fats and carbs but always put protein first. Fats are important because they help to control hunger. It is common to have some limited weight gain after weight loss surgery. They call it a 20 pound bounce. The important thing is not let go beyond this 20 pounds. Most times this weight gain is due to a poor choice of snacks. Snacks should be limited to primarily to 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. Also do not expect to lose weight at a rate similar to right after surgery. Generally if you gained the additional weight over a couple years, then it may take a couple years of watching what you eat to get back down.