James Marusek

Congratulations

My wife stayed with me the two nights I was in the hospital after surgery. She slept on a reclining chair. After surgery, I was hooked up to IVs and other contraptions. As a result whenever I had to get up to walk every 2 hours, or go to use the restroom, I had to drag around a wheeled pole in which all this stuff hung on. So during the first night she helped in keeping me stable. Otherwise I might become entangled and fall down. She also helped in making sure too much wasn't showing on the back end of the hospital gown. But by the second night, most of the stuff was disconnected and it was significantly easier to move around. In the meantime, my wife would watch a little television, read magazines and just try and survive a few miserable days. So make sure that If your significant other stays with you that you make sure she/he brings along material to keep them entertained. Also I did not use pain medicine after surgery. But many patients did. This caused them to be unstable when they walked. Having someone with you during your walks is an important function, until you are off the pain medicines.

Some patients that undergo weight loss surgery experience reactive hypoglycemia. The following are a few links to this condition. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/ http://www.todaysdietitian.com/newarchives/060415p48tip.shtml https://www.stjoes.ca/patients-visitors/patient-education/f-j/PD 7972 Reactive Hypoglycemia after Bariatric Surgery.pdf

It is common to feel apprehension or fear prior to any surgery. There are several different forms of surgery, so you may want to ask about each type. Also many of us have health issues. These can lead to defining the best type of surgery appropriate for our particular issues. I had GERD and RNY gastric bypass is better for this condition than the sleeve because the sleeve will only make this condition worse. You might want to discuss the rate of revision for each type of surgery. If I was going under the knife for this surgery, I did not want to repeat the experience.

My discharge directions read: Wear your TED hose until activity is back to normal. Wear your binder for at least 2 weeks. Your binder is for comfort. So I think what you are talking about is an abdominal support binder. I found wearing it was valuable whenever I coughed to minimize the pain.

Hi Tiera This is the same thread that you posted on 21 November 2015. How has your condition changed during the last year and a half. Have you looked into any of the suggestions given on this board and what were the results?

After my RNY gastric bypass surgery, I was on full liquids for the first 4 weeks followed by pureed foods during the next four weeks. It was only on week 9 that I was permitted to transition to solid foods such as chicken and steak. Even then it was pretty rough on my stomach. Your stomach needs time to heal. There is no reason to rush things. 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.

Good luck on work your way towards surgery. There is a lot of steps to go through but it will be worth it in the end. 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.

After my surgery I found that softer foods such as chili and soups went down much easier than harder foods such as steak and chicken. So I relied primarily on these. I have included some recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf

After surgery, individuals loose weight at different rates. 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 adhere to the program guidelines. Since you are at 3 months, there is one thing you might try if you haven't already. 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. 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. If you can reduce your caloric intake, then you can end a stall. At least that was the approach that I used and it worked for me.

It is common to feel the need to chew. It is part of the digestive process. According to the internet: The action of chewing mechanically breaks down very large aggregates of food molecules into smaller particles. This results in the food having increased surface area, an important contributing factor to good digestion. In addition to the obvious benefit of reduced esophageal stress that accompanies swallowing smaller, rather than larger, pieces of food, there is another very important benefit to chewing your food well that comes with its ability to be exposed to saliva for a longer period of time. Food's contact with saliva is important because it helps to lubricate the food, making it easier for foods (notably dry ones) to pass easier through the esophagus. It's also important because saliva contains enzymes that contribute to the chemical process of digestion. Carbohydrate digestion begins with salivary alpha-amylase secreted by glands positioned near the mouth. This alpha-amylase helps break down some of the chemical bonds that connect the simple sugars that comprise starches. Additionally, the first stage of fat digestion also occurs in the mouth with the secretion of the enzyme lingual lipase by glands located at the root of the tongue. So it is a habit we learned ever since we grew teeth and as a result we crave it.

As you lose weight, the chemicals and hormones that were stored in your fat cells are being released into your body. These will pass through your kidneys and are expelled in your urine. But they can generate a flush of hormones during the weight loss phase. They should simmer down once you transition into maintenance. It is important to meet your daily fluid requirements, because it take fluids to flush these hormones from your system.

Congratulations.

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. After my surgery, my surgeon put me on Omeprazole [Prilosec OTC) which is a proton pump inhibitor for the first year to help my stomach heal properly. I did not experience recurring bouts of nausea. After the first year, I discontinues and all was well. So if you are not taking any NSAIDs such as aspirin and if you do not have an H pylori infection, then perhaps you have an ulcer.

After surgery, I found that softer foods such as chili and soups went down much easier than harder foods such as steak and chicken. So that is what I primarily relied on. I put a few recipes of high protein home made chili and soups at the end of the following article. Generally I would make up a pot, store it in the refrigerator and eat a little bit each day. I like the chili so much that for a while I would eat it for breakfast, lunch and dinner. Anyways if you are supper busy, then this may be an approach that you may use to minimize the time for food preparation. http://www.breadandbutterscience.com/Surgery.pdf

Weight loss is not always a steady drop, but can come in waves. Stalls can happen. It will slow down and level off when you reach the Maintenance phase. But at one month post-op, that is way too soon to be worried about that.

Before my RNY gastric bypass surgery 4 years ago, my snoring at night would keep my wife up all night long. After surgery, I would sometimes wake up to find my wife hovering over me. I was sleeping so quietly, that my wife was trying to detect if there were any signs of life left in me or if I was dead. So the surgery can dramatically reduce the effects of sleep apnea or even put it in remission. In my case this happened within 30 days after surgery.

Congratulations on your surgery. After surgery it is hard to get comfortable, at least for awhile. This is especially true at bedtime. Some people resort to sleeping on recliners. But don't do what I did. I slept on my waterbed. It was so painful getting out of a waterbed after surgery. I found that putting a pillow between my legs helped when I went to bed.

The unknown can always be scary. At your stage, 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 4 years post-op RNY gastric bypass surgery. I wrote a short article that describes my experience. http://www.breadandbutterscience.com/Surgery.pdf

It looks like your surgery is 31 July. I will pray that it is successful. The most important thing to take to surgery is yourself. After the operation remember to walk, walk, walk, it will help to relieve the gas pain. I asked that a trapeze bar be placed above my hospital bed to help me get out of the hospital bed.

Goals weight is an artificial number. Originally when I met my surgeon we set a goal of 190 pounds. I felt that if I could reach 190 it would be a successful surgery. My real goal was to correct the health problems (high blood pressure, diabetes) which were caused by my obesity. At my lowest, I dropped to the 140's. I am 4 years post-op and pleased with the results. As far as a goal, I would shoot for the high side of normal BMI. Normal BMI 18.5-24.9. So for your height of 5 foot 6 inch that would correspond to a goal weight of around 155 pounds (70.3 kg). The reason why I would select that as a goal is because individuals on the high side of normal live the longest. It is important to keep a little fat in your body because when you have a very, very serious illness or accident, you need that reservoir of fat to keep you alive until your body recovers. Anyways that would be a goal from a health perspective.

Webchickadee wrote back in 15 March 2013 on this site: While you CAN damage your stomach (especially in the early post-op days), it would take considerable force and generally speaking, that force would usually come from INSIDE the stomach, by overeating which strains the staples and/or sutures. A leak is life-threatening and any symptoms such unexplained consistent fever greater than 100.5 degrees farenheight, pain: left upper torso shoulder/back, left ribcage, tachycardia (fast heart rate) also increased abdominal pain, shortness of breath, sweating, chills, general malaise could be indications of leak. Make sure you are investigated immediately if you have any of these symptoms (especially if you have more than 1 concurrently). One problem individuals face after surgery is constipation. It can be severe. In my case I had to resort to using glycerine suppositories that I place up my rear end, in order to free the blockage. Eventually I found relief by eating an apple a night just before bedtime. But I had to eat the skin of an apple, not just the pulp for this to work. Other suggestions on how to relieve constipation mentioned on this board are: Smooth Move Herbal Tea Prune Juice (warmed) Prunes (4 in the morning and 4 at night) Magnesium citrate Insoluble fibers (Garden of Life Raw Fiber or Renew Life Triple Fiber). Haribo Sugar Free Gummy Bears Aerobic Magnesium 07 Ground Flax Seeds (but don’t try to grind it yourself). Use 2 tablespoons per glass of water every night before going to bed. Bowel Clear (herbal blend)

We all know that getting plenty of sleep is important to normal functioning and health. And sleep deprivation has been associated with an increased risk of obesity in both animals and humans — it results in hyperphagia (increased appetite) and weight gain. Dr. Hee-Jin IM of the Korea University Anam Hospital in Seoul, Republic of Korea and colleagues focused on the amount of weekend sleep extension (catch-up sleep) that approximately 2200 adults reported getting on a regular basis. The BMIs of the weekend catch up sleepers were significantly lower than that of the folks who did not catch up on weekends — 22.8 vs 23.1 respectively, after controlling for age, gender, average sleep duration, and other demographic factors. http://www.acsh.org/news/2017/06/19/catch-sleep-keeps-one-trim-11445

I used Muscle Milk Light (vanilla creme) and blend in a half a banana for taste. Your taste buds may change after surgery. So be prepared to experiment until you find something you can tolerate after surgery.

Stick to whole food options for snacks; such as nuts, natural nut butters, fruits, raw veggies, boiled eggs, string cheese, yogurt with berries and almonds, tuna pouch. Avoid processed packaged foods as much as possible. Avoid processed sugar.