James Marusek

At 10 days post-op your body is in a major heal mode. You should not be eating chicken nuggets at your stage. For RNY gastric bypass patients the Weight Loss phase is very short. You want to maximize your weight loss during this phase because soon you will slide into the Maintenance phase. So it is very very important to follow the program guidelines. Right after surgery, some individuals will lose weight quickly and effortlessly. But as time goes on, your weight loss will dramatically slow down. So make the most of it and follow the doctor's orders.

The pain sounds like gas pain. If so walking the hallways will do you a lot of good.

I was on Metformin for several years prior to surgery and did not experience any hair loss. One of the causes of hair loss is a lack of protein.

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

There are probably several potential causes for your condition - as others have said. These include: A lack of B12 vitamin. Orthostatic or postural hypotension. https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/symptoms-of-heart-and-blood-vessel-disorders/dizziness-or-light-headedness-when-standing-up Reactive hypoglycemia. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass Vertigo. Dehydration.

Good luck on your recovery. I hope it is swift and painless and with very few bumps along the way.

It sounds like you are on track - 45 pounds down after a little over a month and a half. [But perhaps some of this was pre-op.] Your rate of weight loss will slow down the further you get. This is because you will be adding more food to you daily meals. Then your weight loss will stop and you will quite naturally transition into the Maintenance phase. For me that occurred around 7 months post-op.

Your taste buds may change after surgery. This means that if you plan everything out to a Tee, you may be disappointed with your protein supplement after surgery. The key is be willing to experiment after surgery. You do not have to like protein shakes only tolerate them. I used Muscle Milk Light (Vanilla Creme) powder blended with water and a half a banana. That worked for me. I used a Ninja blender to mix the protein drink. But on the opposite end of the spectrum, you might try premixed Isopure. It is possible to purchase small samples of protein supplements at places like GNC to try them out. After I selected the protein shake I liked, I purchased it in bulk at Amazon for the best price. 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.

You might try taking probiotics. Surgery is usually associated with large doses of antibiotics to prevent post-operative infection. Antibiotics kills not only the bad bacteria in the gut but also the good bacteria. Antibiotics can cause an imbalance of intestinal bacteria. If you have an imbalance of bacteria, this may increase the gas you produce after you eat. Probiotics helps to reestablish your colonies of good bacteria in you gut. Probiotics aim to improve intestinal motility and reduce intestinal fermentation and gas production. Many probiotics are readily available over the counter. Eating yogurt can also promote the growth and reestablishment of beneficial intestinal flora to help overcome bloating and gas.

I have a high pain tolerance. After surgery I left the recovery room I took no pain medicine, I didn't need to because I had very little pain. But remember to Walk, Walk, Walk because it will help to resolve the gas pain. Since surgery is less than a week away, 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.

Congratulations.

I will pray for your speedy recovery.

Congratulations.

Some patients experience a condition called reactive hypoglycemia. It sounds like you are experiencing periods of low blood sugar after you consume foods high in sugar content. Here is a link. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass You can search the internet for more information on this condition.

As you get further post-op the speed of your weight loss slows down and eventually levels off and you stop losing weight and slide into the Maintenance phase. I transitioned into the Maintenance phase at 7 months. So in answer to your question about too much weight loss - the answer is NO. It might be the opposite. One thing to do now at the 3 month stage is to assess your protein intake. Your daily protein requirement is met by a combination of the amount of protein you obtain from food combined with the amount of protein from protein supplements (protein shakes, protein bars). Right after gastric bypass surgery, the volume of food you consume is minuscule (2 ounces) per meal. But as you get further along, the meal volume increases. Therefore you have a very important option available to you. As a result, you can begin to reduce your reliance on protein shakes provided you concentrate on consuming high protein meals. I went from 3 a day, down to 2, down to 1 and eventually none when I reached 1 cup per meal at a year and a half post-op. This is important because protein shakes contain calories. You indicated that you are taking 100-130 grams of Protein now. That sounds high. I was directed to consume 75-90 grams of protein a day but then I was not doing cross fit training. Anyways it is important to have a good daily goal for protein and make sure you are accounting the protein in your meals into your equation, not just the protein shakes.

This itching problem appears to be a problem that others have experience after surgery. Here is a link to the discussion. https://www.bariatricpal.com/topic/251653-help-why-am-i-so-itchy/

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. After surgery, I became lactose intolerant. This generally caused diarrhea. Once I was off the lactose, this problem disappeared. Since your episodes did not occur within minutes of eating/drinking, I do not believe you are experiencing the same problem. Beware some protein shakes contain lactose. I think what might be the cause in your case is a lack of good bacteria in you intestines. Normally after surgery, you are treated with antibiotics. This kills not only the bad bacteria but also the good bacteria in your gut. It is important to reestablish these colonies of good bacteria after you get off the antibiotics. Generally this is done by taking probiotics. So if you haven't done this yet, pick some up at the drug store and try this approach.

Premixed shakes are O.K. provided they are high in protein (around 20 grams) and low in sugar (around 0 grams) Two points to make are that 1) Your taste buds may change dramatically after surgery so what you find tasty today may be awful after surgery. 2) Some experience lactose intolerance for a few months after surgery, so products containing lactose can be a problem.

I will take a several months but sleeping comfortably will slowly return to normal.

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.

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

Your taste buds may change dramatically after surgery so be willing to experiment. 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.

This article describes shaky hands and some of the causes. http://www.webmd.com/brain/shaky-hands#1 One of the causes listed in the article was a lack of B12. Vitamin B12 is very important after surgery. My surgeon recommended 500 to 1000 micrograms sublingual B12 daily or 1000 mcg B12 injection once monthly. When this vitamin is taken sublingual, it is placed under the tongue until it dissolves. Anyways it is worth double checking to make sure you are getting this very important vitamin.

Congratulations.