James Marusek

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. Be forewarned that tomato soup can contain a bit of sugar. A serving (one half cup) of Campbell's tomato soup contains 12 grams of sugar. This is due to the fact that they add high fructose corn syrup.

Congratulations on graduating. I am 4 years post-op RNY gastric bypass surgery and since I transitioned to the maintenance phase at around 7 months post-op, my meal plan has been very similar to a Ketogenic diet. I will pray that you overcome your problem.

Congratulations on being approved for surgery by your insurance company. I would recommend three things at your stage. 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 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 stayed with. I have included some recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf If you want to eat chicken, it is best to tenderize it. For example place a chicken breast in a pot of water. Add a couple chicken bouillon cubes to the water and slow cook it for a couple hours. The chicken should come apart with a fork. You might use a meat tenderizer to soften steaks. That will make it more palatable.

The decision to undergo gastric band surgery is a difficult one in itself to make. But findings from a new study have now made that decision even tougher, because an additional surgery – or two, or three, or more – may also be necessary. Nearly 1 in 5 morbidly obese patients who underwent the weight-reduction surgery were forced to have another operation to correct problems related to the initial surgery, states the authors of a paper published today in the journal JAMA Surgery. Among the malfunctions are incidents when the band that wraps around the stomach slips, or the band erodes into the stomach itself. http://www.acsh.org/news/2017/05/17/1-5-gastric-band-surgeries-require-corrective-operations-11290

According to the internet, there can be several reasons why you feel numbness or a tingling sensation after surgery. https://www.verywell.com/numbness-and-tingling-after-surgery-3156878 Numbness after any surgical procedure is expected for several weeks to months following. As the nerves to the area are traumatized and will then experience a temporary neuropraxia, a transient loss of nerve conduction. This usually resolves over the next 6-12 weeks, but depending on the procedure performed, sometimes much longer.

Strenuous activity often leads to muscle soreness. Finding a way to reduce this unpleasant consequence of physical activity would would be beneficial. After weight loss surgery some of us discovered that we had muscles we didn't even realize we had, due to years of neglect. A team of Spanish researchers believes it has discovered a cocktail that reduces such discomfort. Their formula is a combination of watermelon and pomegranate juice enriched with citrulline and ellagitannins. The authors chose these ingredients because they are linked to beneficial metabolic effects and performance enhancement. For example, citrulline, a non-essential amino acid found in watermelon, helps reduce the accumulation of lactic acid, a major cause of muscle fatigue. Citrulline is also converted to nitric oxide, a chemical that increases blood flow and is believed to boost muscle performance. Pomegranates contain antioxidants and ellagitannins; the former help protect nitric oxide from being degraded, and the latter aids strength recovery. The scientists then recruited 19 young men, aged 18 to 30 with extensive experience in resistance training, into a double-blind randomized crossover study. They tested four different beverages: Watermelon juice (WJ); watermelon juice enriched with citrulline (CWJ); watermelon and pomegranate juice enriched with citrulline and ellagitannins (CWPJ); and placebo (sugary water with pink coloring). Each man consumed 200 mL (about 7 ounces) of one of the beverages at random, and then performed a physically intensive squat exercise. The researchers then collected blood samples and asked the volunteers to rate the muscle soreness of their legs on a scale from 1 to 5. After given a week to rest, the volunteers repeated the experiment with a different randomly selected beverage. This procedure was continued until every volunteer had consumed all four beverages. The results of the study showed that at three time points after the squat exercise (1-hour, 24-hour, and 48-hour), the watermelon/pomegranate cocktail (CWPJ) was significantly associated with reduced muscle soreness compared to placebo. In fact, by 48 hours, athletes reported no muscle soreness at all. Furthermore, when the volunteers drank the placebo, their blood tests revealed a higher concentration of myoglobin (a biomarker of muscle damage) than when they drank CWPJ. The cocktail, therefore, appeared to reduce muscle damage. http://www.acsh.org/news/2017/05/30/juice-cocktail-could-help-reduce-muscle-soreness-athletes-11354

I am 68 years old and had RNY gastric bypass surgery 4 years ago. My age did not seem to impede my healing. Some people say they are more energetic after surgery. I wouldn't say I was more energetic but rather my stamina improved dramatically. Stamina is the ability to perform physical labor. I felt like my stamina was similar to when I was 30 year old. On one of my projects around the house, on the 2nd year post op, I moved 100,000 pounds of gravel by hand along with around 60,000 pounds of concrete blocks and the next year I moved about the same amount of material.

The transition to solid foods can be a rough one. So take your time with this transition. I found that softer foods, such as chili and soups, went down much easier that solid foods, such as chicken and steak. I have included a few recipes in the following article. http://www.breadandbutterscience.com/Surgery.pdf

Congratulations on your surgery and weight loss thus far. I described my experience with gastric bypass surgery in the following article. Perhaps there is something in the article that may be of help. http://www.breadandbutterscience.com/Surgery.pdf

Your weight will fluctuate during the day. My clothes can even add 5 pounds to my total. So just keep following the program guidelines and you will do well. Some times individuals will stress about their daily weight readings. Stressing can sometimes add weight. So many individuals restrict themselves to checking their weight once per week or once per month.

The latest research shows the best results were achieved by combining aerobic (such as walking, swimming, and bike riding) and resistance (such as weight lifting) exercise routine. Dr. Dennis T. Villareal from the Baylor College of Medicine in Houston, TX and colleagues studied the responses of 160 older (over 65) obese people (BMI > 30) to resistance training, aerobic training or a combination of the two types during a 6-month weight loss regime. Most of the participants were female (over 60 percent) and 90 percent were white. The primary outcome the investigators were interested in was any changes in participants' performances on the Physical Performance Test (PPT). This involved tasks such as putting on and taking off a coat, walking a specified distance, picking up a penny, as well as balance tests — all actions which revealed the extent of deficits in physical functioning and possible degree of frailty. In addition, they examined changes in body weight, peak oxygen consumption (a measure of fitness), and a number of other parameters. After 6 months on their respective regimes, all the groups improved their performance on the PPT, but the improvement was greatest in the combination aerobic and resistance group — 21 percent — significantly greater than any of the other groups. In contrast, the control group's PPT score increased by 4 percent, and the resistance and aerobic groups increased by 14 percent each. All the exercise groups lost a similar amount of weight — 8.5 to 9.0 kgm (19-20 lb), which was a significant difference from their baseline weights. They did not differ from each other, however. And the control group's weight didn't change significantly. Peak oxygen utilization also increased significantly in the exercise groups, but not in the control group. Further, both the combination and aerobic exercise groups' change in peak oxygen utilization were significantly greater than than that of the resistance group. http://www.acsh.org/news/2017/05/25/both-resistance-and-aerobic-exercise-good-older-obese-people-—-especially-when-combined-11331

Being weak all the time can come for several issues such as lack of protein, not enough vitamins. 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. Vitamin B12 is also very important in helping form red blood cells and for maintenance of the central nervous system. B12 is also required for synthesis of DNA in the body. A deficiency could cause pernicious anemia, causing mood swings, paranoia, irritability, confusion, dementia, hallucinations, or mania, eventually appetite loss, dizziness, weakness, shortness of breath, heart palpitations, diarrhea and tingling sensations in the extremities. It might also be related to any medication that you are taking. The absorption rate of some medicines will be altered by the surgery.

Congratulations.

Good luck on your surgery and check back with us when you are on the other side and let us know how it went.

As MarinaGirl said, 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. On this change alone, I lost 20 pounds pre-op.

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. After surgery you may find that your taste buds may change. 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 different types of formulations on protein shakes. 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. The banana made it tolerable. 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. As far as protein in meals, I have included some recipes for home made high protein chili and soups at the end of the following article. I found that after surgery soft foods, such as chili and soups, went down much easier than harder foods, such as chicken and steak. http://www.breadandbutterscience.com/Surgery.pdf You will need to be a few months post-op before you begin to use these.

Congratulations.

I had RNY gastric bypass surgery 4 years ago because my obesity was beginning to seriously affect my health. I had Type 2 diabetes (using 2 prescription medicines to control), high blood pressure (another 2 prescription medicines to control), severe acid reflux (GERD), sleep apnea, and frequent urination problems. When I left the hospital 2 days after surgery, I was off all my blood sugar meds and haven't taken any since. Around 2 or 3 weeks after surgery, I was off all my high blood pressure meds and haven't taken any since. So I am pleased with the results from surgery. What I found astonishing is how quickly the weight came off after surgery and how quickly the medical issues were put to bed. This photograph shows you what 6 months can do.

Congratulation on your surgery. Each day will get better, but it will not be overnight. It took me 6 months to reach a happy state when all the problems, issues seemed to melt away.

Dropping clothing sizes was one of the unexpected joys that I had after surgery. I didn't really realize how good that feeling was. Just wait until after you have the surgery. I went from a size 3X in shirts down to a size Small and from a size 46 in pants down to a size 32.

Congratulations on your weight loss thus far. One thing to do now at this 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. 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 offloading of protein supplements is important because protein shakes contain calories. If you can reduce your caloric intake, then you can maximize your weight loss. There are two phases to weight loss surgery. These are the weight loss phase and the maintenance phase. The weight loss phase is fairly short. In my case I transitioned into the maintenance phase at around 7 months.

I was on full liquids for the first month after my RNY gastric bypass surgery and then on pureed foods for the next month. It was only in week 9 that I was approved to move onto solid foods. After surgery your stomach needs time to heal properly. You are only 11 days post-op. It is very important to follow the program guidelines. 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.

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. One thing to do now at your 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. 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.

Since you have not yet had surgery, 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.