James Marusek

Welcome and let us know if we can be of any help. Since you are pre-op, I would recommend you do 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 had RNY gastric bypass and I found the transition to hard foods such as steaks was very difficult. So I relied on softer foods such as chili and Soups. I have included a few recipes in the following article if you are interested in trying this approach. http://www.breadandbutterscience.com/Surgery.pdf

As you transition from the weight loss phase to the maintenance phase, the strategy changes. I am 3 1/2 years post op RNY gastric bypass. The following article describes my approach in the maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

Yes but it might be a bit too soon for you since you are only a month out. Some Protein bars are closer to candy bars than Protein Bars. So make sure whatever protein bars you select that it is 1) high in protein such as 20 grams and 2) low in sugar such as 1 gram per bar. Since problems with constipation often accompany weight loss surgery patients, you might also focus on protein bars with a high Fiber content.

Pretty good for a little over 2 months. Congratulations.

I had RNY gastric bypass over 3 1/2 years ago. I choose RNY because I had severe acid reflux (GERD) prior to surgery. Sleeve will only make this condition worse.

I am sorry you ran into so many problems. I wish you well.

It gets easier but not immediately. It took me 6 months to reach my happy state when all the problems seemed to melt away.

Chewing is part of the digestive process. It releases chemical in your stomach that help digest food. So it is quite natural to feel a need to chew. After my RNY gastric bypass, my regiment was 4 weeks of full liquid, followed by 4 weeks of puree foods, and then only in week 9 was I allowed to transition to solids. Transitioning to solids can be quite difficult. So there is no need to push it. I found that softer foods (such as chili and soups) went down much easier than solid foods such as steak. So therefore I relied heavily on soft foods. I have included some recipes at the end in the following article. http://www.breadandbutterscience.com/Surgery.pdf

I do not think this is limited to just DS. I had RNY gastric bypass surgery. Right after surgery I became lactose intolerant and consuming anything that had lactose such as milk immediately gave me an upset stomach and a quick trip to the restroom with diarrhea. This condition lasted for around 2 months and then went away. After surgery you will generate odors (poo, gas, mouth). This can occur because your body is thrown into ketosis. As you transition from the weight loss phase to the maintenance phase, this problem should be significantly reduced.

After surgery your body is in a major heal mode. Many people find it difficult to meet their Protein and Fluid requirements right after surgery. Just keep trying to up your numbers each day and you should be able to get there. 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.

Hope all goes well for you and your mother. It is hard enough recovering from your surgery when you also have the additional stress of caring for your parents.

Throwing up multiple times per day is not normal. 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 are you able to meet your daily protein, fluid and vitamin requirements? As Berry78 has said, normally what you are describing is either due to a stricture or an ulcer.

Hi Amy. I am not sure if you had bypass surgery or if you are just trying to combat this on your own. I had RNY gastric bypass surgery over 3 1/2 years ago. I transitioned from the weight loss phase to the maintenance phase at around 7 months. I covered the approach that I am using in the maintenance phase in the following article. http://www.breadandbutterscience.com/Surgery2.pdf This might answer some of your questions because you are pre-op. When I was very young, I worked a swing combined with a graveyard shift (around 100 hours per week) for a year. sleep was a difficult problem but it was also very important. I found that they make curtains that let in zero light. This allowed me to sleep effectively during the daytime.

Your Vitamin regiment will depend on the type of surgery that you had. You are posting under the duodenal switch forum but you are identifying yourself as a gastric sleeve patient. The vitamin regiment is very different between these two groups. Your surgeon's office should have defined this for you. According to my Bariatric Discharge Instructions, duodenal switch patients were advised to take: Four children's chewable complete multivitamin's daily 1800-2400 mg. calcium citrate daily A total of 5000 International Units of vitamin D3 daily 1000 micrograms sublingual B12 weekly or B12 injections monthly and 100 mg Thiamin (Vitamin B1) weekly I underwent a different type of surgery (RNY gastric bypass) and I was told not to use gummy Vitamins because they would not be absorbed properly. There are two types of Iron supplements and I was told to use Ferrous Sulfate for best absorption. There are also different chemistries of B12. I use the sublingual B12 and was told to use methylcobalamin.

8 weeks post-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. One thing to do now at this stage is to assess your protein intake. Your protein requirement is met by a combination of the protein from your meals combined with the protein from your supplements (protein shakes, protein bars). Since your meal volume is beginning to increase, that also means that the amount of protein from meals is increasing, especially if you concentrate on consuming high protein meals. Therefore you could be able to reduce your reliance on supplements and the calories they contain. I went from 3 protein shakes a day, down to 2, then 1 and finally zero when my meal volume increased to 1 cup per meal at a year and a half. I found that softer foods such as chili and Soups went down much easier than harder food such as steak, so I relied on them. I have included some recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf

I had RNY gastric bypass surgery over 3 1/2 years ago. After surgery, it can take awhile for you to reach a happy state when the problems seem to melt away. It took around 6 months in my case. I recommend you do 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. I consider this surgery to be one of the best decisions that I ever made.

I am over 3 1/2 years post-op RNY gastric bypass surgery. This is my approach to the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

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. When you are in the hospital for surgery, many people actually gain several pounds due to the fluids they pump into your body. So by the time you leave the hospital you actually weigh more then when you entered. So you need to lose this weight first before you see results.

You are only 6 weeks out !!! After surgery your weight loss is a function of the type of surgery that you had. I had RNY gastric bypass and I lost my weight very quickly but then at 7 months I leveled off after losing almost 120 pounds. But sleeve patients lose weight at a much slower rate. Some are still losing after 2 years. Sleeve patients tend to encounter stalls quite often. So just keep following the program guidelines. It is way too soon to give up.

A recent report in the New England Journal of Medicine describes a randomized trial comparing two types of bariatric surgery with intensive medical treatment with respect to reducing or eliminating T2DM (Type 2 Diabetes). One hundred thirty-four patients were randomly assigned to receive either Roux-en-Y gastric bypass surgery, sleeve gastrectomy, or intensive medical interventions. The participants were followed for 5 years, and the primary endpoint was determining the level of glycated hemoglobin (also called hemoglobin or HGB A1C). HGA!C is a way of estimating the amount of glucose in the blood over time: higher levels suggest that diabetes management is ineffective, with too many high values. Diabetic individuals are counseled to try to keep this number at or below 7 percent — in the current study, the goal was a glycated hemoglobin of 6 percent or less. At the beginning of the study, the average HGB A1C was over 9 percent. By the 5 year time point, at least some of the patients in each group had achieved that goal, with more of the surgical patients doing so than the medical intervention patients. Only five percent of the medical patient group reached A HG A1C OF 6 percent, compared to 29 percent of those receiving gastric bypass and 23 percent of those with sleeve gastrectomies — both these decreases were significantly greater than those seen in the medical intervention group. http://acsh.org/news/2017/02/16/bariatric-surgery-more-effective-long-term-medical-treatment-t2-diabetes-10872

Many health insurance companies require that you undergo a 6 month medically supervised weight loss program that includes diet and exercise.

Good luck on your surgery and check back with us when you are on the other side. Also remember walk, walk, walk. It helps the gas pain go away.

In reviewing my discharge instructions. One of the criteria for calling your surgeon's office is "New onset of upper back or left shoulder pain." As you lose weight the fat that cushions your bone joints disappears, therefore some patients report bone joint pain after weight loss. But in your case 3 weeks post op is a little too soon to experience this. Getting tired after doing light housework could be caused by a number of things. Top on the list is that your body is still in a major heal mode. But other things might be starting to show up. For example if you were taking prescription medicine prior to surgery, the dosage rate of this medicine might need to be adjusted. Not meeting daily Vitamins, Protein, fluids levels might also come into play. If you experience dizziness and fainting combined with the weakness, it might point to reactive hypoglycemia.

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 avoiding NSAIDs is important to prevent ulcers. NSAIDs include 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.