James Marusek

Congratulations on your weight loss. 44 pounds in 9 weeks is very good. I found that softer foods (chili and soups) went down much easier than harder foods (steak and chicken), so this is what I primarily relied on. I have included a few recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf

Congratulations on your weight loss thus far.

Generally when you went in for the operation, you gained weight because they filled your body with fluids. You have to lose those first before you begin to see the scales move. You body is in a major heal mode at the moment. It will take a few weeks of being on the mend and then the numbers will begin to drop. 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 people find it difficult to meet their daily protein and fluid goals the first couple weeks because their body is in a heal mode. Just keep working on it and you should get there.

Congratulations.

Congratulations. Walking helps with relieving the gas.

Recently I started to use a product called Bai. I buy it by the case at Sam's Club. They have a lot of good flavors.

I looked at your before and after photo and it is not the same person. Perhaps it is the nose piercing! To answer your question - stalls happen. 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 extra 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 approach I used to break my stalls. The transition to solid foods such as steak and chicken was difficult for me. So I relied on softer foods such as chili and Soups. I made my own and fortified them with extra protein. I would mix up a pot and it would last me for several days. It also had an advantage because it allowed me to exactly know how much protein, calories I was consuming at each meal. At the end of the following article, I have provided recipes if you care to try. http://www.breadandbutterscience.com/Surgery.pdf I had type 2 diabetes prior to my RNY gastric bypass surgery 3 years ago. I was taking two types of prescription medication. And even that was not controlling my blood sugar levels. When I walked out of the hospital 2 days after surgery, I was off all my diabetes medication and I haven't taken any since. I periodically test my blood sugar levels and they are good. I think the key to keeping the diabetes in remission after surgery is to stay away from all processed sugars.

Welcome Grandma Jan and let us know if we can be of any help. I am 3 years post-op RNY gastric bypass surgery. This article describes my experience after the surgery. http://www.breadandbutterscience.com/Surgery.pdf

According to my post-op directions from my surgical team, the daily Fluid requirement was 64-80 ounces per day. So since you can only drink 20-30 ounces per day, this does appear to be a problem. Four things come to mind. Recovery from Surgery: During the first few weeks after surgery, may individuals report difficulty consuming the required amount of fluids. This is because their new stomach is in a major heal mode. Generally if they continue trying each day, they can increase their daily totals and reach the required goal. You are 4 weeks out and should be closing in on your daily goals. So this points to a problem. Definition of Fluids: Fluids are more than just Water, for example milk. It is the water content of the Protein shake that you consume. It is the water in Soups. It is the water you drink when you take your daily Vitamins. It is drinks such as tea, decaf coffee, Crystal Light etc. Inability to attain Fluid Goals: May be due to a stricture. Taste of Fluids: After surgery, taste buds can change. After my RNY surgery 3 years ago, I could even stand the taste of water in the hospital. It tasted overly chlorinated and I just couldn't force myself to drink it. I found that the answer was experimentation. In the hospital, they gave me sugar free popsicles and they became my best friend. For example, I found that I could tolerate flavored water, so Crystal Light became my friend. For some individuals, the fluids are temperature sensitive. They like drinks hot or they like drinks cold. For me I found that I loved Hot Drinks when it was cold and there was snow on the ground. I drank hot chocolate but I used the "No Sugar Added" variety. I also liked fine English teas. I liked cold drinks on a warm summer day, such as Crystal Light and now my new favorite is Bai.

It is important to walk for around 30 minutes each day (or equivalent) prior to surgery. It speeds up the recovery process and also reduces the pain levels from surgery. During the 6 months prior to surgery, I walked every day. Immediately after my RNY gastric bypass surgery 3 years ago I walked every 2 hours round the clock while I was in the hospital. I refused all pain medicine after I left the delivery room. I didn't really need any. I had very little pain.

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

Your PCP is only a minor part of the weight loss surgery process. He/she is only the initial gatekeeper that refers you to a specialist, the surgeon that will perform the surgery. Since he made the referral, then he is out of the equation. The weight loss surgery can be a long process involving many individuals. Within many states, there are Bariatric Surgery Centers of Excellence. These are like a full meal deal. These center of excellence puts these specialist under one umbrella. These include the hospital, the surgeon, the nutritionist, pre-op testing, training, psychologist and sponsors of bariatric surgery support group meetings, and specialist that deal with the insurance companies. So I would recommend that you find a center of excellence and work the process through them.

I had RNY gastric bypass surgery 3 years ago. One of the requirements for surgery was to give up caffeine and carbonated beverages. I went cold turkey on my 6 diet coke a day habit when I began the 6 month diet and exercise program. Base on this change alone, I lost 20 pounds. It was rough the first week because I suffered from severe caffeine withdrawal (severe headaches and body aches).

Well, go sign yourself up and try it. I am 3 years post-op RNY gastric bypass surgery. After surgery, my body was constantly changing and I had to adapt. This meant a lot of experimentation. I lost my ability to swallow medium to large size pills. Therefore I had to split or crush them. My ability to swallow returned after about 2 months. I became lactose intolerant. Therefore I couldn't drink milk. This problem disappeared after about 2 months. Some people describe life after surgery as a journey. And in any journey, there is change after change and experimentation is the key. New joys and new problems around every corner. Find your way along this journey. Learn the best way you can adapt. Why are you still on clear liquids after 3 months? I found that solid foods (steak and chicken for example) were difficult to eat, so I relied on softer foods (such as chili and soups). I put a few recipes for home made high Protein chili and Soups at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf

After surgery, your body is in a major heal mode for several weeks. It is common for patients to be unable to meet their daily Fluid and Protein requirements during this time, but just keep trying to meet your daily goals and you should be able to get there.

After surgery, I found that I could no longer swallow medium to large pills, so I had to crush or split them. My Calcium supplements were the worse. In powder form they tasted like chalk and didn't dissolve in Water. I mixed them with a glass of Crystal Light and that was the only way I could drink them. I am not sure that taking apart capsules is the best idea. The capsules are part of the delivery system. They are to ensure that the contents travel properly down through your stomach acids. Perhaps they can provide these antibiotics in another form. Also after your treatment of antibiotics make sure that you take Probiotics for a couple weeks. Antibiotics destroy bacteria in your body - both bad and good (beneficial). Therefore it is important to take probiotics to reestablish colonies of good bacteria in your gut.

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

As the weight fell off after surgery, the fat that normally provided a cushion between my legs began to disappear. Therefore I had knee bone rubbing against knee bone and this was uncomfortable. I found that slipping a pillow between my legs at night helped.

I am not a doctor nor do I have medical experience. So take what I say with a grain of salt. I am 3 years post-op RNY gastric bypass surgery. It seems like you have multiple conditions, so let me talk about these individually. General 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. It looks like you have lost the weight are in the Maintenance phase. So generally your meal volume allotment is now large enough that if you concentrated on eating high protein meals, you might not need to add protein supplements (protein shakes, protein bars). I found it difficult to transition to solid foods (such as steak and chicken) after surgery so I primarily relied on softer foods such as chili and Soups. I fortified these with extra protein. I have included the recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf But if you are having difficulty keeping food down, then you may have to go back to protein supplements just to ensure you get the proper amount of protein in daily. Ulcers 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 eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed. Also 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. Passing Out The fact that you have passed out a few times might be due to a condition called Reactive Hypoglycemia. This is a low blood sugar condition that affects some RNY patients. Here is a link that describes the condition. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass

I am 3 years post-op RNY gastric bypass. It is interesting how quickly type 2 diabetes can be sent into remission by the surgery. I was off all my diabetes meds two days after the operation when I left the hospital and haven't taken any since.

I am 3 years post-op RNY gastric bypass surgery. This is my impression of the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

@@dustyd I will pray that your surgery is successful.

I am sorry to hear of your loss. But sometimes the decisions of others are beyond our control. But I do remember one time when I changed someones life and I did it with shock. This happened almost a half century ago. We were about to have our first child and were doing it through natural childbirth. We were having the birth, the Bradley Method. I had close friends Nathan and Gloria. They were married and she became pregnant about a month or two after my wife. They were both obese and she was having a hard time with the pregnancy. Nathan was completely oblivious to his wife's pregnancy and this was driving Gloria crazy and furious. We tried to encourage them to attend natural childbirth classes together to bring them closer together, but it was a lost cause. Now my wife was a month overdue. She had gained the weight of 52.5 pounds at full term. She was only 95 pounds at the beginning of her pregnancy. For the past several months, we were getting daily calls from Nathan and Gloria about status. We were even getting calls from Gloria's parents. It was putting way too much pressure on my wife. Well, Nathan and Gloria were going away to visit with his parents for the weekend. Thank goodness! Saturday morning arrived, my wife got up and said it was time. I took her to the hospital, she had our child by around noon and walked back from the delivery table. She spent one night in the hospital and then I took her home. Late afternoon on Sunday, we got a call from Nathan and Gloria. "How is everything?" I said, "The contractions are getting stronger. Oh, by the way, we bought some new shutters for the front window, would you like to come over and see them?" Well I knew Nathan and Gloria could not refuse an invitation to come and visit. They showed up about 15 minutes later. I staged my wife in the middle room on a recliner nursing the new child. Nathan was a talker. The first time we met we had a 4 hour conversation. Not much of a conversation, he spoke for 4 hours and I listened. Once and awhile I would interject a few words in order to change the subject, but he picked up the new subject and spoke for another hour. That was the way he was - full of excitement and enthusiasm. They arrived and I brought them into the first room and showed them the shutters. Then we walked into the middle room. Nathan was in full stride talking 90 miles an hour when he turned the corner. He stopped. Dead stopped. I could see the wheels in his head literally turning. He saw my wife sitting on the recliner holding a toy baby. Why is she holding a doll? No, it moved. It's alive, it's a baby. They had a child. He didn't say a word for around 2 minutes. I think it set a world record. Up to that time, Gloria had been making a big point about all the complications with her pregnancy. It was causing a lot of friction between them. But this experience showed them that it wasn't such a big deal. Life happens. Children happen. And it happens naturally. After that Nathan and Gloria signed up for classes and a few months later Nathan was in the delivery room welcoming the birth of his new child.

When you discuss the surgeon's recommendation for the type of surgery, make sure you ask him/her about the rationale. You seem to already have your mind made up, but you need to understand why the surgeon is making a certain recommendation. Sometimes there are very good reasons why he/she is making a particular recommendation. Sometimes the decision is optional. Sometimes the decision is based on expertise, what type of surgery the surgeon has the most expertise with. Sometimes the decision is not even driven by the surgeon but by your insurance. Some insurances cover one type of surgery but not another.

I am 3 years post-op RNY gastric bypass surgery. From my perspective you are talking about two different things: feeling full and hunger. For me, whenever I eat too much, I feel pre-dumping triggers. These can vary by individual. They can include: sneezing, excessive mucous creation, hiccups,congestion, the instantaneous change in the way food taste (from good to bad). If I continue to eat once I hit this stage, the next spoon of food causes me to transition into full blown dumping. This is 4-6 hours of misery. Generally the only relief is to find a toilet and force myself to vomit the food out. The issue is not feeling full, it is the inability to consume a larger amount of food than my new stomach can hold. These syndromes for the most part happen after you transition from the full liquid/pureed food stage into the solid food stage. [The part of the anatomy that triggers the full feeling is at the top of your stomach. When your stomach was larger pre-surgery, you would have to eat a lot before you hit your trigger. But now that your stomach is small, it should take very little. And if you are meticulous about meeting the requirements of meal volume by measuring every meal, hopefully you will not exceed this amount and transition to dumping. Dumping is a learning tool, so become very aware of the pre-triggers that your body generates.] After surgery, I completely lost my sensation of hunger. This sensation returned about a year after surgery, but it was not nearly as strong as pre-surgery. Before I had surgery, hunger was constantly, continually gnawing at my bones. When I ate a meal, I was already thinking about my next meal. There is also a phenomena known as head hunger. This is when the body thinks it is hungry; but isn't. In other words, it is all in the head. Right after surgery, the body craves the sensation of chewing. So in the beginning when one is on the full liquid/pureed food stage, one is deprived of the sensation of chewing. For most of our lives we have chewed foods and they release digestive fluids in our stomach. It is a built-in process. Head hunger is also the sensation of lost memories of the tastes of our favorite foods. It might also be triggered by a break in the habit of eating. I love to eat food. I mean really love to eat fine meals. After surgery, food almost became my mortal enemy. Food losts it's taste and flavor. It was totally bland. After several months, I discovered that mixing food groups together, such as in chili and Soups help to restore some of the flavor. Spices also helped. Now that I am 3 years post-op, some of the original flavor is starting to return.