James Marusek

It is common to do a little experimentation after surgery. That is how we learn. Some people can tolerate anything after surgery while others have problems and can tolerate very little. Weight loss is achieved during the short weight loss phase through meal volume control. The two operative words here are short and volume. So if you want to maximize your weight loss during this phase, you need to adhere to the program guidelines. I slid into the maintenance phase at 7 months.

After surgery I completely lost my hunger. It was not difficult to lose weight when constant hunger was held at bay. This condition does not last forever but for about the first year. This loss of hunger does not kick in until you reach the solid food stage at about 8 weeks post-op. Many people complain about head hunger. Your body is accustomed to a habit of eating. We chew our foods and chewing releases chemicals in our body that help with the digestive process. Generally after surgery when we are on liquid phase or pureed phase we do not chew. So our body misses this natural process. And this need to chew may be responsible for head hunger. Headaches??? I suffered severe headaches and body aches for a week when I went off all caffeine. Luckily I kicked my caffeine habit long prior to surgery so they would not conflict with the recovery from surgery. That is my only thoughts on this one. 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. Fourth, I thought by having the gastric bypass , the calorie intake would be minor but I have read several sources where it says, we will take in all our calories eventually. Maybe not in the first months but we will end up taking all the calories. I am 5 years post-op and what you are saying makes no sense to me AT ALL. The itching of the incisions are a good sign that your wounds are healing. But it will take several weeks. The knots inside your body will take longer to disappear. The big one where most of the surgery took place will take around a year before you can no longer fell it.

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 (1) avoidance of NSAIDs, (2) antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition,(3) H pylori infection should be identified and treated, if present. The other area that you should explore is the fact that you might have a stricture.

Another comment: Prior to surgery I had a condition excessive sweating, or hyperhidrosis. I would drive in the middle of winter with snow coming down with the windows wide open because I was too warm. Shortly after surgery, that condition went into remission. Now my body is much more sensitive to the cold. So the lack of mosquito bites might be related to the decreased amount of sweat my body produces.

When I was a young lad over half a century ago, I went on a long march hiking over a plateau in Baja California in Mexico for a week. After a few days a grim built up on my skin. This grim could not be washed off with water. (It took soap to remove it.) But I noticed after the grim buildup, the insects (biting flies and mosquitoes) no longer bothered me. Have you conducted any experiments with essential oils that could possibly alter our skin's microbiota/odor signature? I am currently experimenting with controlling body odor. I have had underarm odor for my whole life. Deodorants do not really mask the odor. So I am experimenting with an alternate approach. Baking Soda kills the bacteria that produce body odor. So I mixed some Baking Soda with Coconut Oil in a small jar and added a little Lavender essential oil into the mix. And I apply this lotion to my underarms each morning. It seems to kill the bacteria under my arms without any adverse reactions.

Congratulations on your weight loss thus far. I found that eating softer foods (such as chili and soups) went down much easier than harder foods such as (steak and chicken). As a result I relied on these. I have included a few recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf

It is common to be nervous prior to surgery. So here are a few suggestions to get your mind off the 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. I have included my 6 month post-op comparison photograph as an example. 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 will make a couple observations: As the article said "Obviously it costs more to make plus-size clothing because of the amount of fabric used". But another cost is the inherent cost of producing low volume products and selling that merchandize. Generally when I was obese, I found that I could not longer buy clothes in department stores. They no longer carried my size clothing. As a result I was forced to buy clothes at specialty stores that catered to "big and tall". Although their prices were somewhat compatible with department store prices, their clothes rarely went on sale. Since I generally bargain shop and buy clothing at 60% to 75% off retail price, pricing was a major consideration. Another statement was “If smaller-sized people aren’t getting discounts, then plus-sized people shouldn’t have to pay a surplus." Does that mean children size clothing should be priced the same as adults? I think retail generally prices their merchandise by what the market will bear. What keeps prices in line is competition. There are many small towns scattered across the U.S. These small towns had mom-and-pop stores. So generally if you went to town to buy groceries or clothes you found the prices were sometimes 50% greater than the prices in small cities. Then malls came into being and people began to travel to the cities for weekly runs. The Walmarts and similar stores came into being many located in rural areas which provided competition and prices came down and many small town stores dried up and went out of business.

I had RNY gastric bypass surgery and I completely lost my appetite for the first year after surgery. But generally I don't know how common this is in sleeve patients. It is critical that you meet your daily protein, vitamin and fluid requirements after surgery. Food it less important. Do you have other symptoms like nausea? unable to drink fluids without vomiting or hurting? This might be a sign of a problem such as a stricture or ulcer which is common after surgery.

Before my surgery I used this product for scars and it seemed to work well, so thanks for the tip.

The condition is called orthostatic or postural hypotension. Dizziness or light-headedness when standing up occurs as a result of abnormal blood pressure regulation. Normally, when people stand, gravity causes blood to pool in the veins of the legs and trunk. This pooling lowers the blood pressure and the amount of blood the heart pumps to the brain. Low blood flow to the brain causes the dizziness and other symptoms. To compensate, the nervous system quickly increases the heart rate and constricts blood vessels, which rapidly returns blood pressure to normal before symptoms can develop. Prior to surgery, I was taking 2 types of prescription medicine for high blood pressure. As I was losing weight pre-op, I was able to cut my dosage in half. Then a couple weeks after surgery, I noticed my blood pressure was getting much lower, so I completely went off all my meds for high blood pressure. That condition went into remission and stayed there. I am now over 5 years post-op.

No, not tested, unless it is part of by bariatric surgery blood workup each year.

I suspect that it will not. 10 days + Aug 14 = Aug 24 < Aug 28. You will probably be given antibiotics while you are in the hospital. But you might alert your surgeon's office to make sure which is what you plan to do.

I lost around 20 pounds in my pre-op diet that lasted 6 months. It added to the 100 pound weight loss after surgery for a total weight loss of 120 pounds. So any pre-op loss moves you further towards your goal.

It depends on the direction from your surgeon. Mine directed me to consume 75-90 grams of protein per day.

Right after surgery your body is in a major heal mode. Many patients find it difficult to meet their protein and fluid daily requirements during the first few weeks. Just keep trying. 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 varieties 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. Without sufficient protein, your body will scavenge protein from other areas of your body, such as your muscles. Protein is extremely important after surgery as its job in the body is to build and maintain tissues including your body's major organs and skeletal muscles. Protein deficiency, when continued over a long period of time can cause a disease known as protein caloric malnutrition. Common symptoms are poor healing, fatigue, hair loss and muscle wasting. Immediate post op, protein promotes healing of the staple line and incisions. Your daily protein requirement is met by a combination of the amount of protein you obtain from food combined with the amount of protein from protein supplements (protein shakes, protein bars). Right after surgery, the volume of food you consume is minuscule. But as you get further along, the meal volume increases. Therefore you have a very important option available to you. As a result, you can begin to reduce your reliance on protein shakes if you concentrate on consuming high protein meals.

You might discuss that with your surgeon's office.

I came across a study this morning on Cancer that was rather interesting, so I thought I would share it. But first I might discuss the implications as it applies to me and other that undergo weight loss surgery. I had RNY gastric bypass surgery over 5 years ago. Prior to surgery I was diabetic. This condition went into remission right after surgery and I went off all my blood sugar diabetic prescription medicine the day I left the hospital two days after surgery and haven't taken any since. I periodically test my blood sugar levels once per month and they remain fine. In tandem with my surgery, I changed my eating habits. I strictly avoid processed sugars. I have a sweet tooth and that is one of the major causes that contributed to my weight gain over my lifetime. I limit myself to artificial sweeteners (such as Splenda and sugar alcohols), to natural low calorie sweeteners (such as Stevia) and to the natural sugars found in fruits and milk. I read the labels of all food that I consume. I look at the grams of sugar per serving. If it is above 5 grams, I look at the ingredients. The ingredients are listed in order by highest percentage, and if the first 5 ingredients contain processed sugar (in any of its many forms), then I avoid this food, like a plague. O.K. now onto the study. Basically the findings of this study indicate that people who rely on artificial sweeteners experience a 20% reduction in cancer rates. Now, researchers claim that artificial sweeteners prevent cancer. Do they? It's biologically plausible. Cancer cells undergo what is known as the Warburg effect. Typically, our body cells generate energy through a process known as aerobic respiration, but cancer cells ramp up fermentation, instead. Just like a muscle doing vigorous exercise, cancer gobbles up glucose (a sugar) and spits out lactic acid. Hypothetically, depriving a cancer cell of sugar could remove an important fuel source. A team of researchers conducted a cohort study that examined the self-reported dietary habits of 1,018 patients during and after chemotherapy for stage III colon cancer. Their main finding was that artificially sweetened beverages lowered the risk of cancer recurrence or death by about 23%. Do Artificial Sweeteners Prevent Cancer?

It is common to be afraid just prior to major surgery. To get your mind off things, I recommend the following unless you have already done these. 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.

Which is exactly the point. Healthy skepticism is not bad. But look at both sides of the picture. Do not automatically dismiss a study because of where some of the funds came from. Just keep an open mind. And science is generally not based on one study alone but the replication of research findings by other independent research groups. So the authors of the original article that I cited came to the following conclusions: However, the one thing that the authors cannot overcome is the fact that food frequency questionnaires (FFQs) are notoriously unreliable. People regularly underreport how much alcohol they consume, for instance. I barely remember what I ate for lunch, and that was just a few hours ago. There's simply no good way to get around this shortcoming, though the fact that the authors detected something of a dose-response (i.e., the more artificial sweeteners a person consumed, the less likely he or she was to develop cancer) strengthens their case. Additionally, there is the nagging issue of confounding. People who drink artificially sweetened beverages may have other health habits that are responsible for lowering the recurrence of cancer. Perhaps people who drink more Diet Coke also eat more celery. The authors did their best to adjust for such confounding, but there's always the possibility that something goes undetected. Overall, I find the result interesting but unconvincing. If artificial sweeteners really do decrease the recurrence of cancer by more than 20%, then they should begin a clinical trial pronto. That is why I thought the authors of the article presented a well balanced article. And also their conclusion was to target more research to prove whether these findings were real or due to other confound issues.

But it should cut both ways. If you are leery of any research published by those who receive funding from pharmaceutical companies then one should also be leary of any research published by those who receive money from environmental groups. It cuts both ways. Environmental groups receive large amounts of money based on the fear that they generate about the impact of chemicals and also by their ability to bring those fears into the courtroom to support large jury awards to plaintiffs. It is the research that they pay for that underpins their claims of harm. Although in this particular case the real companies that have a financial interest are those companies that produce artificial sweeteners not the pharmaceutical company. So do any of the researchers have stocks in artificial sweetener companies?

Right after my surgery I became lactose intolerant. Within minutes of consuming milk or other diary products, my stomach became upset and then there was a quick trip to the bathroom with diarrhea. Some protein shakes contain lactose. Anyways this condition went away in around 2 months time.

A few years after surgery, my blood workup showed that I needed more iron. My nutritionist directed me to take it in the form of ferrous sulfate for the best absorption. A year later, my next blood work showed that I had too much iron, so they said I could cut back on the iron. I took my iron supplement just before bedtime because I wanted to make very sure I was giving it a 2 hour separation between when I took in any form of calcium, not just the supplements (such as calcium from milk, butter, yogurt or other dairy).

Deemar007 I was not trying to be accusatory but more like I was passing on my observation. It came out wrong, so I apologize. That was not my intent.

The hard knot can take sometime to disappear. It is the main area where the surgery took place. Mine finally disappeared after a year.