James Marusek

Take your time. Don't rush into things. Remember you are in for the long haul. 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. Your protein requirement is met by a combination of the protein you obtain from food combined with the protein that you obtain from supplements such as Protein shakes. So just monitor your daily intake and if you come up short add another Protein shake to the mix.

Congratulations on your upcoming surgery and let us know if we can be of any help.

Congratulations.

Good luck on your upcoming surgery and let us know if we can be of any help.

Good luck on your surgery and check back with us when you are on the other side.

Creatine is a nitrogenous organic acid that occurs naturally in vertebrates and helps to supply energy to all cells in the body, primarily muscle. So low creatine levels might be one of the reasons why you have a lack of energy.

Having a low BUN level may not be a problem but having a high one is. The kidneys are two bean-shaped organs located on each side of the spine. They’re responsible for filtering out of the blood waste products, excess Water, and other impurities. These important organs also control the pH, salt levels, and potassium levels in the body. The kidneys even produce hormones that manage red blood cell production and regulate blood pressure. A blood urea nitrogen (BUN) test is used to determine how well your kidneys are working. It does this by measuring the amount of urea nitrogen in the blood. Urea nitrogen is a waste product that’s created in the liver when the body breaks down Proteins. Normally, the kidneys filter out this waste, and urinating removes it from the body. BUN levels tend to increase when the kidneys or liver are damaged. Having too much urea nitrogen in the blood or having high BUN levels can be a sign of kidney or liver problems.

Perhaps you have an ulcer. This could explain some of your conditions. Or you might have a pre-existing condition called H pylori infection. 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. So the general advice from above if I am interpreting it properly is to avoid NSAIDs (such as 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] and but use proton pump inhibitors [Omeprazole, Pantoprazole, Esomeprazole, Lansoprazole, Rabeprazole, Dexlansoprazole, Rabeprazole sodium, Pantoprazole sodium, Esomeprazole magnesium, Omeprazole magnesium, Naproxen/Esomeprazole, Esomeprazole sodium, Omeprazole/Bicarbonate ion] and/or sucralfate [Carafate] antacid. After RNY gastric bypass surgery, my surgeon put me on Omeprazole [Prilosec] for a year to lessen the affects of surgery on my stomach. So if you are suffering from an ulcer, this approach may be beneficial.

@@pdallariva, to recap, this is what you have told us. You had RNY gastric bypass surgery on June 7, 2016. You cannot tolerate Protein shakes, other protein supplements, or even milk. And you cannot eat food. You had blood work done and it came back all good. (except you are losing muscle from lack of protein intake). Also you are losing your hair. Another sign of a lack of protein. You were admitted 4 times for dehydration and low potassium. You had a stricture and underwent dilation three times. You have been unable to take your Vitamins. You have a lack of energy and an inability to get a restful sleep. On the plus side you can tolerate Water. The three most important elements after RNY gastric bypass surgery is to meet your daily protein, Fluid and Vitamin requirements. And this is just not happening. So something is seriously wrong and your surgery team needs to solve this problem or at least explain what the root problem is. You say that you cannot tolerate vitamins. What have you tried? What are you taking? B12 is a very important vitamin after surgery. It can be taken sublingual. You just place a small tablet under your tongue for a minute or two and it dissolves away. Are you taking this. There is another option. Give yourself a B12 injection once per month. I did it for a year. B12 deficiency will definitely drain away your energy levels. So what are you doing to get your B12 in? The focus is protein, fluids and vitamins.

I am 3 years post-op RNY surgery. After the surgery, I found that meat was hard to digest. I found that using meat in chili and soups went down easier, so that is what I stayed with. As time went on, my stomach became more tolerant and I enjoy a good steak every now and then. But I eat only 1/4 of it now instead of a full steak. So most times it becomes left-overs.

Congratulations.

Good luck on your surgery and check back with us when you are on the other side.

I believe that it is common for some individuals to feel exhausted for the first few weeks after surgery. It could be caused by several problems. 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 this is where I would put my focus on. B12 is important as well as Iron. Iron supplements must be time separated from the intake of Calcium supplements by at least 2 hours. They do not mix. So generally I take my iron at the end of the day just before bedtime. It might also be a drug interaction. Pain medicine can cause exhaustion. Also if you were taking medication prior to surgery, these medicines now may not be absorbed in the same way after surgery. I was diabetic prior to surgery. My surgeon took me off all my diabetic medicine when I left the hospital 2 days after surgery. If he had not, then the medicine could have driven my body into a state of low blood sugar, which would make me severely lethargic among other symptoms.

Sometimes individuals develop a blockage after gastric bypass surgery. This is called a stricture. This makes eating and drinking rather difficult. Sometimes this will heal on its own but other times a minor medical procedure is used. Here is a link about this. https://www.realself.com/question/stricture

There are many benefits to weight loss surgery. In my case it drove my diabetes, high blood pressure, GERD, and sleep apnea into remission. But there are other subtle changes to one's health that are less observable. A study published Thursday in The New England Journal of Medicine found excess weight was linked to eight additional types of cancer— stomach, liver, gall bladder, pancreas, ovary, the brain tumor meningioma, thyroid cancer and multiple myeloma— after reviewing more than 1,000 related studies. So driving down the weight can reduce the risk of cancer in several areas. "The burden of cancer due to being overweight or obese is more extensive than what has been assumed," Colditz, deputy director for the Institute for Public Health at Washington University School of Medicine in St. Louis, said in a news release. "Many of the newly identified cancers linked to excess weight haven't been on people's radar screens as having a weight component." http://www.foxnews.com/health/2016/08/25/being-overweight-may-increase-risk-8-cancers.html

Here is another link to this research. It contains a little more data from this study. http://acsh.org/news/2016/08/25/latest-iarc-report-connects-fatness-with-more-cancers/

My wife is a professional seamstress. The same thought crossed my mind. But it didn't work out for me. I had RNY gastric bypass surgery and the weight came off so fast that it was totally impractical. Since you are a sleeve patient and since your type of surgery means that weight comes off generally at a slower pace, it might work for you. I did find that belts came in very handy. Also a western leather belt can be cut down and new holes punched so that I will track with you weight loss and still not look altered.

Congratulations

Tip: Walk every two hours. It will help with passing gas and make your recovery quicker. Tip: Make sure they have a trapeze bar installed on your hospital bed. It will help you get up with less pain when you walk every two hours. I took no pain medicine after I left the recovery room. I didn't need any. I may be the exception. I don't think pain medicine does much anyways, what you really need is a muscle relaxer. Tip: Your tastebuds may change after surgery so be prepared to experiment.

There was one scar where they tied everything together and it left a hard mass. I am 3 years post-op and all the other ones healed fine. It goes with the surgery.

Your body will fluctuate several pounds throughout the day. I always weigh myself first thing in the morning butt naked. That is the lowest reading of the day. But after I eat and drink I can gain a pound or two. When I add my clothes, my wallet, my shoes, my leather belt, my glasses. That can easily add another 5 pounds.

Congratulations and let us know if we can be of any help.

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 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. Some individuals find it difficult to meet the daily requirements after surgery. This is because your stomach needs time to heal and this can take a couple weeks or more. But just keep trying 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. The fluid requirement is met by a combinations. 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. There are so many options available for protein supplements, that experimentation is the key. But after you try them all 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.

You will probably not experience a full feeling until you reach the solid stage. liquids tend to pass right through the stomach. So be a little patient.

There are two phases to weight loss surgery. These are the Weight Loss phase and the Maintenance phase. The goals of these two phases are different and also the approach to use in these two phases are also different. I am 3 years post-op RNY gastric bypass surgery. My impressions of the Maintenance phase are included in the following article. http://www.breadandbutterscience.com/Surgery2.pdf