James Marusek

I used volume rather than weight. I am a gastric bypass patient and my food intake during the weight loss phase is more restrictive than those who had the sleeve. Since many of your questions are basic ones. I thought it might help you to read a short article that I put together about my post op experiences. Remember they may be a little different than yours because you had the sleeve. But having said so, I think it may be worth while for you. http://www.breadandbutterscience.com/Surgery.pdf

When you take calciums it is important to spread it out over the day. I generally take 2 Citrical supplements every 2 hours until I meet my daily calcium requirement. [I am a gastric bypass patient and my requirement is 1500-1800 mg per day. Sleeve patients requirement is less. It is 1200 to 1500 mg per day.] I just put them all in a small finger bowl first thing in the morning and take a couple out at a time throughout the day until the bowl is empty. If I am on the go, then I put them in a small zip lock back and take the bag with me.) As far as the Citricals are concerned be aware that the dosage rate is based on consuming 2 tablets. I didn't realize this at the beginning so I was only taking around half the recommended daily dose for the first month after surgery. It is also important to have at least a 2 hour separation between your calciums and your iron. So I generally take the calciums during the day and the iron at night. The iron may be a separate pill or part of your multivitamin. Once you get the system down, it becomes routine. So don't get overwhelmed at the beginning.

I was a little confused because I didn't know where you were on your gastric bypass surgery journey. It appears that you are at the very beginning in the pre-op stage. I went through 6 months of physician monitored pre-op dieting and exercise program. At the beginning of the program, I decided to apply the rule of "no soft drinks, no caffeine". I figured that since I had to give this up anyways, I might as well implement this change at the very beginning of the process. So I ended by 6 diet coke a day habit. I suffered through a week of withdrawal pain (severe headaches and body aches). But then I was O.K. I think I lost 20 pounds pre-op on this change alone. During this 6 month period, I started to do journaling. I tracked everything I ate. This helped because I know how many calories foods had. It also showed me what fast food restaurants and which type of food to stay far away from. Another aspect of this program was exercise. I began hill walking for a half hour per day. The walking was very important because it is an integral part of the program. Right after surgery, you have a massive amount of gas locked in your body. This is the root cause of much of the pain that patients experience. I took no pain meds after surgery. I didn't need to. I walked every 2 hours around the clock after surgery and I experience minimal pain as a result. You diet will change dramatically over the next few years (pre-op phase, first couple years post-op in the weight loss phase, and then when you arrive at the maintenance phase). So be prepared for changes ahead. It is important to follow the dietary directions in the post-op weight loss phase. This phase is where you will achieve the most weight loss in a very short time. Don't second guess this phase.

Congratulations. 😉😎😊😀☺️

paulamelton I wish you well for your surgery. As far as your mother is concerned. 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. Some people experience problems after bypass surgery. But it is not too common. Generally the problems are related to ulcers. If that is the case, then the following 3 items should be looked at. First, sometimes the cause is from the use of NSAIDs such as aspirin or Excedrin (which contains aspirin). There are a variety of over-the-counter medicine that are NSAIDs. They must be avoided. Second, using a proton-pump inhibitor can help. I was prescribed Omeprazole (over-the-counter Prilosec) for the first year after surgery to allow my stomach to heal properly. There are a variety of proton-pump inhibitors on the market today. Third, make sure you mom was tested for Helicobacter pylori infection. It is a simple test to do. Even your GP can do it. Around half the people in the world have this infection. So it is fairly common. It is also very difficult to cure. It might take a couple treatments using different cocktails of antibiotics to cure it.

This doesn't sound typical or normal. I am 5 years post op and I can eat almost anything. The only thing that would cause me to vomit is if I consumed too much food at once. Meat can be difficult to eat. But some of this is in the preparation. For example the best way to fix chicken is to take a chicken breast and boil it slowly in water for a couple hours until the chicken comes easily apart with a fork and add a chicken bouillon cube for seasoning. Has she ever approached this problem with her surgeon. It may be that she has a stricture.

My wife was with me the 3 days I was in the hospital. I was a little wobbly the first day. I went for walks every 2 hours after surgery. I had to drag around a pole on wheels that held my IV and other stuff. So she really helped the first day but after that her being there was not crucial. I did not take any pain killers after surgery so I was fairly stable on my feet.

I have found that softer foods (such as chili and soups) go down much easier than harder foods (such as chicken and steak). Before surgery I loved shrimp and crab legs . But right after surgery, they tasted very bland. But your taste buds will change back over time. I am 5 years post-op and I can eat shrimp and crab legs and love them again. Anyways I put some recipes together for home made high protein chili and soups. They are at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf

I will pray for you.

Not everyone experiences hair loss. I didn't. It is really important to follow the daily recommendations for protein to prevent hair loss. Generally those that experience this condition experience this for a short time and then their hair grows back in. This loss of hair issue normally happens when they are near their weight loss goal, several months out after surgery. Since you are at the beginning of this process, I would recommend 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.

I believe many people on this site advised to use Gas-X to relieve gas. I am a believer in probiotics. Normally during surgery you are given antibiotics. These not only kill off the bad bacteria but also your good gut bacteria. So anytime you end a treatment of antibiotics one should immediately follow it with probiotics to restore your good gut bacteria. Here are a few past links: https://www.bariatricpal.com/topic/255323-gas-x/ https://www.bariatricpal.com/topic/232381-gas-x-strips/ https://www.bariatricpal.com/topic/149698-gas-x-soft-gels/

I never used pain meds after surgery. Most of the pain was gas pains. Walking controlled that pretty well.

I will pray for you speedy recovery.

Right after surgery, I wondered if I did the right thing. It was a little rough and I worried just like you. But each day things slightly improved. It doesn't happen overnight but it is pointed in the right direction. It took a full 6 months before I was really happy with the decision. Some people right after surgery cannot even get a good nights sleep. Therefore they are deprived of the rest they need to restore their bodies. Some on this site found it easier to sleep on a recliner for a few days. So this site is full of people who lived problems after surgery and found ways to deal with them. So if you have a specific problem put it out there and someone may have a specific answer that will provide relief. 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 hopefully, your surgery team gave you detailed requirements for the various daily vitamin requirement, the fluid requirements and the daily meal volume and food types (liquid, puree, solid) as a function of time. Mine were provided in a 1 inch thick binder. If this was not spelled out in detail, we will try and help. I wrote a short article about my experiences after surgery. It may help. http://www.breadandbutterscience.com/Surgery.pdf

This is my before and after photo at the 6 month mark. Quite a lot can happen in 6 months.

I went cold turkey at the beginning of the program. When I went thru the psych eval, the psychologist was trying to determine if I had the proper mindset for the surgery. I told him I already went cold turkey on the caffeine/carbonated beverage requirement. He took the paperwork and wrote passed.

This is fairly new technology and there are some potential risk in using this technology. At least there should be some awareness of the dangers. One of the components of DNA testing is the add-on paid service of identifying genetically linked health conditions. But one of the problems is the DNA testing lacks the accuracy to make this determination. Therefore individuals are receiving misinformation about potential conditions that may be locked in their genes and may make invalid decision based on this misinformation. Refer to: Home DNA Kits Lack Accuracy Another consideration is who other than yourself has access to this data. So let us consider a hypothetical. There is a mass murder on the loose. DNA was collected from the crime scene but did not match anyone in the database. The mass murderer decides to do an ancestral genetic test. Let us say he was curious if there were other mass murderers in his genetic line. Are criminals that dumb. I suspect that some are. The result - his ancestral DNA test is used to put him behind bars. Is that far fetched. Perhaps. But something is currently taking place that is rather close to this. This is called genetic genealogy. Unknown criminals are tracked down through their genetic DNA of their close relatives. Refer to: DNA, genetic genealogy made 2018 the year of the cold case: 'Biggest crime-fighting breakthrough in decades' Now I am all for putting criminals behind bars. But let us enter the world of science fiction. Suppose in the near future someone is able to manufacture DNA. A criminal organization might be able to plant manufactured DNA evidence at a crime scene. If they were able to hack into a DNA database of individuals then they could select the individual they wanted to frame. So it might be used to put the innocent behind bars.

Well you are getting close. I will pray for you. Here are 3 last minute recommendations: 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 gas pain after 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.

If that does''t work you might try some nonconventional approaches. I am a believer in the use of essential oils. Put a dab of oil on one wrist and then rub your wrist together or you can put a dab of oil on the soles of your feet. Do this one or two times per day. The oil is absorbed through your skin and into your blood supply within minutes. Some suggested essential oil blends for stomach ulcers are: Thieves Oil - a mixture of Clove, Lemon, Cinnamon Bark, Eucalyptus Radiata and Rosemary. DiGize - a mixture of Tarragon, Ginger, Peppermint, Juniper, Fennel, Anise, Patchouli and Lemongrass. Melrose - a mixture of Rosemary, Melaleuca Alternifolia, Clove and Niaouli. Other single essential oils that might help are: Lemongrass, Copaiba, Lemon, Myrtle, Patchouli, German Chamomile, Myrrh, and Peppermint. Another approach is to use herbal teas. In fact, peppermint and chamomile teas are anti-inflammatories that can soothe your ulcer pain and encourage healing. Brew your tea and allow it to cool until just warm—too hot and you'll irritate your ulcer. Stir in some raw honey for its antibacterial qualities as well as for its sweet flavor. Here is a link that discusses other nonconventional approaches. Ten ways to relieve stomach ulcers at home

Frustr8, I am sorry to hear that you are still having a hard time of it. My father suffered from ulcers for years and it is hard to deal with. I did another internet search and came across the following article. Treatment - Stomach ulcer I think you checked off most of the potential treatments, but there is one that I didn't know if you looked at. H2-receptor antagonists Like PPIs, H2-receptor antagonists work by reducing the amount of acid your stomach produces. Ranitidine is the most widely used H2-receptor antagonist for treating stomach ulcers.

You are 2 weeks post-op. You said, "I get this awful tightness in my chest and then pain." According to my hospital discharge directions I was told to report such a condition to my surgeon's office. One of the primary concern is a blood clot in the lungs. Do you have shortness of breath? Review this link. Pulmonary Embolism Or it could be something else. Anyways let your surgeon's office know of the complication this close after surgery.

Congratulations. 😉😀☺️😎💥💃

To disagree with someone is not bullying. To employ the tactics of name-calling is. This site should be a safe place for honest talk and respectful discourse. But respectful discourse does not mean that you cannot debate issues, just do it in a respectful manner.

There is little doubt that sedentary behavior is bad for your health. Many people claim that “sitting is the new smoking,” even though the two are not really comparable. Smoking is orders of magnitude worse than being sedentary, and given the choice, people should opt to do neither. The interesting thing is that increasing your level of physical activity results in health benefits regardless of what your baseline step count is. In one Canadian study, diabetics were randomized to usual care, or an exercise prescription given to them by their physicians. The intervention group improved their daily step count from around 5,000 steps per day to about 6,200 steps per day. While the increase was less then what researchers hoped for, it still resulted in improvements in sugar control. Another study found that women enrolled in a walking program for 24 weeks reduced their blood pressure by 11 points; even though they only increased their step counts to about 9000 steps per day. In yet another study, a weekly physical education class was able to increase daily step counts in menopausal women and resulted in improvements of their cholesterol profile even though they too were slightly shy of 10,000 steps per day. So where did this notion of 10,000 steps per day come from? In 1965, Japanese company Yamasa Toki introduced their new step-counter, which they called Manpo-Kei. This translated into “10,000 steps meter” and they marketed their device with the slogan, “Let’s walk 10,000 steps a day.” Japanese walking clubs were fairly popular at that time and the idea of a 10,000-step target seems to have caught on because the slogan was catchy and people tend to like nice round numbers. The rest, as they say, is history. The idea of 10,000 steps per day may have originally been a marketing slogan, but it does seem to be roughly useful. A sedentary but otherwise healthy person who does not exercise regularly might take about 6000-7000 steps per day in the course of their normal every day tasks. This is a rough average and it obviously varies from person to person, but is a useful estimate for our purposes. Now, a 30-minute walk will generally involve about 3000-4000 steps, depending on a person’s stride. So if you take a sedentary person, and get them to add 30 minutes of walking to the their daily routine, they will likely get to around 10,000 steps. Source: 10,000 Steps: Myth Or Fact?

Congratulations. 😊😎☺️😀😉