James Marusek

My taste buds changed immediately after surgery. But as time wore on over the next year or two, my taste returned back to near normal. I found that mixing food groups together and by using spices definitely help in bring back the taste. So I recommend soups and chili.

I am 70 and still have all my original teeth except for on molar and my wisdom teeth. I had gastric bypass surgery 5 years ago and it did not affect my teeth at all. Like others have said, it is extremely important to follow the surgeon's guidelines on daily vitamin intake after surgery. A lack of calcium can destroy your teeth and bones.

Being dizzy, lightheadedness, fainting can also be caused by low blood sugar. There is a condition that occurs in Gastric Bypass patients called Reactive Hypoglycemia. One man in our bariatric surgery support group developed that condition. After fainting one time, he figured out the cause and then learned how to control the condition. Here are a few links. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/ https://www.stjoes.ca/patients-visitors/patient-education/f-j/PD 7972 Reactive Hypoglycemia after Bariatric Surgery.pdf

The reason why is because human fat is a very good insulator. Lose the fat and as a result, you become very sensitive to the cold.

Fat is a good insulator. As you lose the fat from your body, you are also losing the insulation it provided. I use to drive around in my car with the windows open all the time, even in the winter when there was snow coming down. Not anymore since I lost the weight. I am very thankful for the individual that created chemical hand warmers. It really helps when I shovel snow in the middle of winter.

Wait until you start dropping clothes sizes. I went from a 3X in shirts down to a size small. That was JOY.

Generally when we undergo an operation in a hospital we are treated with antibiotics to protect us from harmful bacteria present in a hospital. This kills not only the bad bacteria but also the good gut bacteria in our colons. As a result, many of us take probiotics to reestablish the colonies of good bacteria in our gut. I came across research of gut flora this morning that seemed interesting. Our body’s microbiome, the bacteria living in symbiotic harmony in our gut provides us with a source of wellness. Two small, exploratory studies, analyzed microblome in terms of change and resilience. Influence of Geographical Change In the first study, researchers looked at the diversity of our gut flora as individuals immigrated and assimilated, changing diet and geography. The inspiration may have been the finding that immigrants to the US often develop weight gain and Western diseases - obesity, hypertension, diabetes, and coronary artery disease. While refeeding of individuals who came from food challenged areas is felt to be part of the issue, changing diet has also been implicated. The authors collected stool samples, 24-hour food recall surveys and demographics from two distinct Thai populations, the Hmong and Karen. Individuals included those still living in Thailand as well as immigrants (1st generation) and their children (2nd generation). Thai immigrants were chosen because the study was conducted in Minnesota a central site for their immigration; women formed the predominant research population because they were more frequently the immigrants. Americans of European ancestry served as the control. * Microbiologic richness and diversity were greatest in current Thai residents. * 30% of that diversity was lost in the first generation immigrants, and the diversity continued to decline and resemble that of the control group as time in the US increased and in the 2nd generation, American born Thai children. * Bacteroides strains replaced Prevotella strains among immigrants, the extent of that shift again associated with length of residence in the US. * The loss of Prevotella was felt to be the driving force behind a decreasing functional ability of the microbiome to degrade dietary fibers indigenous to the native Thai diet. Think of it as use it or lose it. * Dietary shifts to a Western diet was felt to account for only about 16% of total variation. * Westernization of the microbiome began within nine months of arrival. Resilience A second, "proof of concept" like study, looked at 12 healthy men treated for four days with an antibiotic cocktail meant to mimic common first-line choices for intensive care patients. [1] The outcome was the effect on the gut microbiome over a subsequent six month period, again measured by stool cultures taken at various time intervals. It is no surprise, at least to clinicians, that the antibiotics did not sterilize the gut, but it did bring about changes. * There was an immediate drop in the diversity and richness of the microbiologic populations, but by Day 8 diversity was returning although it never reached baseline values. * By Day 8, the relative abundance of about 50 species changed, some increasing and others decreasing – clearly, the ecology was different. And while some bacterial species were still absent after six months, by Day 42, the ecology had, for the most part, returned to its baseline. * Antibiotic resistance was only one of many virulence factors enhanced by the antibiotic exposure that lead to an early increase in pathologic bacteria. But over time the pathologic bacteria were again overrun by more symbiotic species. Virulence factors * Interestingly, Clostridium species which had not been seen initially were now present – this is a species that forms spores as protection in an unhealthy environment and then returns to its other form when “the coast is clear;” it is the source of antibiotic-related hospital-acquired morbidity, C. difficile diarrhea. Source: I Sing The Body's Microbiome So what are some of the takeaways? First, antibiotic treatment does not sterilize the gut microbiome. But it does reduce the diversity and richness of gut bacteria. Recovery of the colonies of good gut bacteria begins about 8 days after the antibiotic treatment end. So a patient is more vulnerable to pathologic bacteria during that time. For example - it is the source of antibiotic-related hospital-acquired morbidity, C. difficile diarrhea. Therefore using probiotics after the antibiotic treatment ends and you leave the hospital is a good approach in order to quickly reestablish the diversity of good gut bacteria.

What worked best for me was walking. It is also important to reestablish your colonies of good gut bacteria after surgery that have been destroyed by antibiotics. Generally in a hospital they administer antibiotic to kill off any bad bacteria lingering in a hospital setting. The problem is that antibiotics also destroys the good gut bacteria in the process. This good bacteria can be restored by using probiotics. Many on this site have used Gas-X to help control this problem. Also be aware that there is a stage called "Never Trust a Fart". You will know it if you encounter it. Luckily this stage is rather short.

Overweight people are invisible. Society tends to ignore them. I noticed several months after surgery I became visible again to society. But I still remember how it felt to be invisible for decades. So I adopted a very simple routine. Whenever I am in a store or restaurant and people wear name tags. I note their names. And as I am paying I call them by name. "Jane, how are you today. George, have a good day." Generally their reaction is quite remarkable. They look up. They stopped being invisible for a few seconds and fell appreciated. On another side note: 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 or through your sweat. 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.

After gastric bypass surgery, the amount of food you consume is minimal. Instead your body is using the stored fat in your body as fuel. According to the internet: the liver utilizes the fat present in the body as an energy source, producing “ketones” in the process. This is known as “ketosis” – and is the process from where keto diets get their unusual name. These ketone bodies come in three common forms; acetoacetate, beta-hydroxybutyrate and acetone. In large quantities they are removed from the body in the urine or through exhalation. [That is why it is so very important to meet your daily fluid goals.] Ketones can have quite a characteristic smell; they often make the dieter’s breath smell quite sweet and fruity, quite distinct from typical halitosis. Excessive volumes of acetone, however, can smell rather different. Acetone on the breath is most commonly likened to the smell of nail varnish remover. Source: https://ultradex.co.uk/ketosis-breath-causes-solutions-for-bad-breath/ Another symptom of ketosis that can be rather unpleasant is dryness in your mouth, sometimes accompanied by a slight metallic taste and an acetone breath. Now I never really smelled my breath after surgery. But others complained that my breath smelled like death itself. But I did suffer from something called dry mouth. I found that a mouthwash called Biotene corrected that condition. Now I do not remember anything like a Keto rash. After surgery my body looked like it underwent WW II. It was totally covered with bruises. The bruises were in part a product of the blood thinner I had to take for a few weeks after surgery to prevent blood clots. These will heal. But I did experience another condition. When you lose significant weight, you are left with excess skin. Nowhere is this visible more than on your face. I developed very fine wrinkles; almost paper thin crinkles, all over my face. I looked like I was a hundred years old. I think women have the upper hand on this problem. My wife told me to use Bio-Oil available in most drug stores. I apply a dab on my face each morning and I am good to go. I have been using this for over 5 years and it solves that problem.

Frustr8, I had one suggestion. I am not really familiar with your case but I wanted to make sure that one more base was covered. 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. I just wanted to make sure you were tested for Helicobacter pylori infection. This is a fairly common infection. About 50% of the worlds population has it. The symptoms are exasperated by gastric bypass surgery. It is a simple tests. But if you have it, it will be a little difficult to kill this bug. It will take a cocktail of antibiotics to treat and the initial treatment may not kill the infection and you might have to take a second round.

I remember a few months after surgery using ketchup. It was like tasting hot sauce. Luckily the taste buds seem to adjust back over time.

Focus on the upcoming surgery. 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. [With chronic arthritis in your feet and knees, this might be difficult. But try - gas pain will present itself during the first week after surgery and walking helps take this away.] 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.

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 formulations 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. Remember your taste buds may change dramatically after surgery. So be prepared to experiment with protein shakes after surgery until you find the right one that fits.

According to the guidelines I received for gastric bypass, I was on full liquids for the first 4 weeks post op, pureed foods for the next four weeks and only at week 9 could I transition to solids. I found that many solid foods (such as chicken and steak were difficult to get down). As a result I stayed with softer foods (such as high protein versions of chili and soups). I have included a few recipes at the end of the following article. http:// http://www.breadandbutterscience.com/Surgery.pdf Also there is no reason to accelerate your transitions to solids. Just take your time. So to answer your original question. It is difficult to answer. If you are unable to get down liquids then I would suspect a stricture. If you are unable to get down even small amounts of pureed foods, I would suspect a stricture. But your problem may be that you are transitioning to solids too soon.

After surgery your taste buds change. So the protein shakes that are acceptable pre-op can be quite awful post-op. The key is experimentation. There are a lot of formulas for protein shakes and you need to find the right one. Remember this is only temporary. As your meal volume increases over time, you can offload the shakes for the protein you obtain in meals.

It will dramatically be affected by the type of surgery that you had. In my case I has gastric bypass and the weight loss was very dramatic. In the case of sleeve patients, their weight loss is at a much slower pace and they encounter many stalls. 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. So just follow the directions from your surgeon and nutritionist and do not worry. At 8 days post-op, you are still in the healing stage.

Because I snored, my surgeon recommended that I meet with a pulmonologist. I did this and and after examining me, the doctor indicated that I most likely had sleep apnea. He recommended that I have a sleep study performed. I declined. My reasoning was that since most individuals resolve this problem after surgery, that I didn't see the need to go this route because I was going for the surgery. Anyways my pulmonologist coundn't find a defect in my logic and approved me to go ahead. For several years prior to surgery, my snoring kept my wife awake all night long depriving her of her well deserved sleep. She was a light sleeper. Anyways a few months after surgery, sometimes I would wake up in the middle of the night and find my wife hovering over me. I asked her what she was doing. She said I was sleeping so silently, she though I had passed away in the night and she was looking for signs of life. So one of the effects of surgery in my case was to vanquish my sleep apnea.

I put some recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.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 daily protein requirements by food alone, so therefore you need to rely on supplements such as protein shakes. Many people experience problems eating and drinking after surgery. Two of the medical conditions that can contribute to this problem is the development of strictures and ulcers. So if you find that your problem is extreme (such as constant vomiting) then I would recommend working this problem out with your surgery team. That is why they are there. The transition to hard foods (such as chicken and steak) can be rather rough. As a result I have relied on softer foods (such as high protein chili and soups). I have included a few recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf

I had both shingle vaccines a few years ago and I have not experienced a shingles rash. So the vaccine appears to work for me. I am 70.

Fear is a natural reaction prior to major surgery. Since you are approaching your surgery date, here are a few things to do: 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.

In general the level of pain declines on a daily basis after surgery. The pain in your shoulder may be of concern. Generally when you are discharged from the hospital, you are given discharge instructions, they include a number of conditions which should be reported to your surgery team. On my list one of the conditions is "New onset of upper back or left shoulder pain." So if the pain is in your left shoulder, you may want to report that condition to your surgeon.

Welcome to the site. Right after surgery can be the most difficult time and generally things vastly improve the further you are out. I had gastric bypass surgery over 5 years ago and I am well pleased with the results. If there are specific problems that you encounter, please bring them up and I am sure someone will respond with bits of advice.

Well, surgery is right around the corner. Here are three last words of advice. 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 (gas pains) 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.