James Marusek

Congratulations on your weight loss. Don't be too worried that you may be losing too much. The weight loss phase will come to an end and you will slide into the maintenance phase. It will happen quite naturally. The three most important elements after weight loss 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.

Be forewarned your taste buds may change after surgery. So don't invest too much time prior to surgery in selecting your Protein shake. Be prepared to experiment after surgery. Remember you do not have to like the protein shake you select, you only need to tolerate it.

I had RNY gastric bypass surgery over 3 years ago and did not experience any of the symptoms you describe. So off hand I would say those symptoms are not normal. According to the internet: Neurogenic stuttering may occur after a stroke, head trauma, or other type of brain injury. With neurogenic stuttering, the brain has difficulty coordinating the different components involved in speaking because of signaling problems between the brain and nerves or muscles. CAUTION: I am not a medical doctor and have no medical expertise; so take whatever I say with a grain of salt. One of the dangers of surgery is the formation of blood clots. As a result, most patients were put on blood thinners after surgery and request to walk every day after surgery. If a blood clot forms somewhere in the body (usually the heart) and it can travel through the bloodstream to your brain. Once in your brain, the clot eventually travels to a blood vessel small enough to block its passage. The clot lodges there, blocking the blood vessel - causing a stroke. The medical word for this type of blood clot is embolus. So I would recommend that you discuss this with your surgeon next week if not sooner. Your doctor should be made aware of these symptoms immediately.

One condition many patients experience is a strong desire to chew food after surgery. Since most times after surgery you are restricted to full liquid or puree, it doesn't meet the requirement to chew. As you chew, your body releases digestive fluids that help with breaking down food. So it is a natural process.

I live in southern Indiana. We had a couple inches of snow. But it was bitterly cold. On one night it got down to -6 degrees F and then -2 on the next night. But now the temperatures are beginning to rise. On a side note, whenever we get a cold snap it generally last 3 days and then the temperatures recover.

If you buy premixed Protein shakes in the store make sure they have good protein content and low sugar. Sugar alcohols should be O.K. It is much better than sugar. There are two phases after surgery. These are the Weight Loss phase and the Maintenance phase. At 4 years post-op, you are in the maintenance phase. The following article describes my experience with the maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

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. This is how I broke the few stalls I encountered along the way.

According to the internet: Normal stools can vary in shades of brown, mostly due to diet. ... If your stools are pale or clay-colored, you may have a problem with the drainage of your biliary system, which is comprised of your gallbladder, liver, and pancreas. Bile salts are released into your stools by your liver, giving the stools a brown color. Here is a useful link. http://www.mayoclinic.org/stool-color/expert-answers/faq-20058080 Generally when you are in the hospital, they give you antibiotics as a precaution. This will not only kill harmful bacteria but also the good bacteria in your gut. So therefore it is important to reestablish this good bacteria and that is done by taking Probiotics.

Dumping is bad. You periodically head to the restroom to vomit over a 4 hour time period. You cannot sleep. After RNY gastric bypass surgery the part of your stomach that process fat and sugars has been cut away. So if you consume those foods it can lead to dumping. After about a year, your intestines will figure out something is wrong and pick up the slack by learning how to process these foods. Therefore you can introduce them back into your diet again. Having a sweet tooth is not good. I had one and as a result I developed diabetes. My surgery placed that disease into remission. And as a result, I generally do not consume sugar. I rely on synthetic sweeteners such as splenda and sugar alcohols and no calorie natural sugars like stevia. There are more and more products showing up on the grocery store shelves today that use these sugars. And they can satisfy your sweet tooth without gaining the weight or becoming diabetic.

@@JHDR if you decide to drink hot cocoa, remember to buy the sugar free variety in the supermarkets.

At 4 weeks post-op, your surgeon recommends that you get off the Protein shakes and try to get most of your protein from meals. That might be difficult to do, maybe even impossible because your new stomach may not be able to tolerate it. When my stomach was healed sufficiently to consume solids, I basically relied on homemade high protein meals. I included some of the recipes that I used at the end of the following article, if you want to try them. But this really sounds like very strange advice from your surgeon to avoid protein shakes at your stage. http://www.breadandbutterscience.com/Surgery.pdf

Look at it from a different perspective. If you die prematurely from medical conditions related to obesity, who will lose out. It will be your kids. How will they cope? So take care of yourself so you can take care of your kids.

I have never experience this problem. When I go and pay property tax at the county courthouse, I have to pass thru a metal detector. Sometimes it trips off, probably because of my belt buckle. Generally what the guard says, is try and pass through the center of the detector and not lean to one side. That seems to work for me.

Good luck on your recovery. Some people find it easier to sleep in a recliner for the first few days after surgery.

Dumping syndrome is a good educational tool. It quickly teaches you what you do not want to do ever again.

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 of the almost magical properties of weight loss surgery is the loss of appetite. Prior to surgery hunger was constantly continually gnawing at my bones. When I was eating a meal, I was thinking already about what I would eat for my next meal. That is one of the reasons why I became obese. Without hunger it was not difficult to lose weight. In answer to your question. This loss of appetite will continue for around a year and then you will develop hunger again but it won't be at the same level that it was pre-surgery. So at your stage keep meeting your daily protein, fluid, vitamin requirements; walk for around 30 minutes per day or other equivalent exercise; and consume the volume of food specified for your daily meals and you should do fine. You will not starve.

A new study reported in JAMA Surgery investigates the long-term durability of weight loss after bariatric surgery. Led by Dr. Matther L. Maciejewski from the Durham Veterans Affairs Medical Center in Durham, NC, the researchers used data on mostly (over 73 percent) male veterans from the federal Veterans Administration. Participants' BMIs on average ranged from 43 to 48, putting them in the extremely obese category. They underwent one of 3 types of bariatric surgery: about 1800 had Roux-en-Y gastric bypass (RYGB); about 250 had adjustable gastric banding (AGB); about 380 had Sleeve gastrectomy (SG); and about 5300 served as weight-matched non-operated controls. The men in each group averaged between 52 and 53 years old. Four years post-surgery, all the different surgeries resulted in a loss of initial body weights: 28 percent in the RYGB group, 11 percent in the AGB group, and 18 percent in the SG group, indicating a substantially larger loss with RYGB. By the 10th year post-surgery, the RYGB group lost 21 percent more of their baseline weight than did the non-surgical control group: a difference that was statistically significant — the RYGB group had lost nearly 29 percent of their initial body weight at that time, while the control group lost only about 7 percent. http://acsh.org/news/2016/09/02/bariatric-surgery-works-do-effects-last-9958

I had RNY gastric bypass surgery over 3 years ago. Now for my questions! -what is dumping? After RNY gastric bypass surgery, the part of my stomach that normally processes fats and sugars was cut away. Therefore if I ate fats and sugars, it can flow through my stomach and produce diarrhea. Also because after surgery, my stomach was significantly reduced in size, if I consume more than the size of my new stomach, I get sick and vomit the contents of my stomach over several hours. Dumping is a tool. Once you experience you do not want to repeat the experience so you become sensitive to the pretriggers. -how common is hair loss? I did not experience any hair loss but some people do. It is important to consume the required amount of Protein, otherwise your body will scavenge protein from other parts of your body such as you hair. Hair loss is more common during the weight loss phase and should cease when you reach the maintenance phase. -do you have any tips? I 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. -how long did you take off work? I had the surgery after I retired. The amount of time off from work will depend on your physical condition and how strenuous your work is. Some people return to work after 2 weeks, but that can vary a lot. -how long is the process from your first appointment to the actual surgery date? In my case it was about 9 or 10 months. It is driven by meeting the requirements of my health insurance company. -anything else you think I should know? I am 68 years old. I had the surgery because my condition of being overweight was destroying my body. I had developed high blood pressure, diabetes, sleep apnea and GERD. All those conditions were resolved shortly after surgery. These conditions went into remission and stayed there. I physically now have the stamina that I had when I was in my 30's. For example during each of the last couple years, I moved over 100,000 pounds of gravel and concrete blocks by hand for one of my home building projects.

Several months after my surgery, I developed severe constipation. The kind where you do not have a bowel movement for 7 days. When you get this bound up, sometimes the only cure to free yourself up is to use a glycerine suppository which you have to insert up your rear end. That is the only way to free yourself. Constipation can be caused by a lack of fluids. So make sure you are meeting your daily Fluid requirements. The following are some examples of what individuals on this website reported to use to combat constipation during past threads. Apples with the skin 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) Low Fat Bran Muffin (recipe). 80 calories each 1 cup flour 2 teaspoons baking powder ½ teaspoon baking soda ½ teaspoon cinnamon 2 cups bran Cereal 1 ¼ cups milk 1 egg ½ tablespoon applesauce optional: banana, berries, mini chocolate chips Bake 400° F for 22 minutes

After my RNY surgery, I found that I could no longer physically swallow medium to large pills, such as my Citricals. I had to crush them. After about 2 months, I discovered that I could swallow them again.

There is about 5 grams of fat in an egg. There is around 25.6 grams of fat in a 3.5 ounce serving of T-bone steak. So generally after surgery, it is recommended to concentrate on consuming leaner cuts of meat. The fat content of an egg should not be a problem. Generally your stomach should be able to tolerate it. But that cannot be said about a T-bone steak.

After RNY surgery, the part of your stomach that normally processes fats and sugars has been cut away. Therefore if you consume fats and sugars it can lead to dumping. After about a year, you body figures out something is wrong and your intestines learn how to process fats and sugars and then it is possible to consume those again. During this later stage, my nutritionist recommends a balanced diet of equal amounts of Protein, carbs and fats, with always protein first. I am over 3 years post-op and I avoid sugar like a plague. I incorporate fats into my diet because fats take away hunger. So in my stage, I consume butter, whole milk, my own homemade whipping cream in my coffee (using splenda not sugar), and non-lean cuts of meat. I generally allow myself one meal a day that includes complex carbs, such as bread or Pasta. At 3 months post-op, stay away from fats and sugars and complex carbs. Generally don't count carbs but pay meticulous attention to meal volume. The weight loss phase is fairly short and you want to maximize your weight loss during this stage because before you will know it you will slide quite naturally into the maintenance phase.

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 it is important to pack protein such as premixed Protein shakes (high in protein and low in sugar) or if you are further advanced from surgery, protein bars. Whenever I am traveling I pack Quest protein bars. It is equally important to have access to liquids. Most people take bottled Water with them wherever they go. I like a drink called Bai which I buy by the case at Sam's Club. There is one version of Gatorade which has low sugar and good electrolytes that some people use. Not at the beginning but later, maybe a year out, you can return to eating out at restaraunts. But concentrate on high protein, small portion, low sugar foods. I am over 3 years post-op RNY and I might eat 2 crunchy tacos at Taco Bell. (no drinks, nothing else, only tacos) or a chili at Wendy's.

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.

Sometimes you just have to say NO when someone wants you to volunteer. I do it quite often. I pick and choose. You probably don't need the added stress after undergoing surgery a few months ago and having to comply to the detailed regiment of post-op requirements. 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. This was the method I used to break my stalls.