James Marusek

Hello Bobbi and welcome.

Two days after surgery when I left the hospital, I was off my blood sugar medicine. Three weeks later I was off my blood pressure medicine. Other problems went into remission. I never had back pain. In my support group, one individual was going to have a knee replacement, but after weight loss surgery found out that they no longer needed it. So I suspect, the loss of weight might help relieve back pain.

I don't know about having more energy, but I find that I have more stamina. At age 65, before surgery I might go to the mall and after a half hour find a bench and sit and wait for my wife to finish shopping. Now when I go to the mall, I walk around for several hours without resting. This winter we had a lot of snow. My driveway is 800 feet long. So I cleared it a dozen time, without even building up a sweat. One downside is that because I do not have so much fat, I am more susceptible to the cold. But then I found out about hand warmers.

I don't think I cared about the way I looked before surgery. But after I lost the weight after surgery, one of the unexpected changes was that I began to care a little more about the way I looked. It was actually fun to replace my wardrobe. Its nice to be able to go into a department store and actually buy clothes instead of a specialty big and tall shop. And the clothes look good on me. In shirts I went from a size 3X down to a size small.

I am 11 months post-op. I have dropped from a size 3X in shirts down to a size Small and from a size 46 in pants down to a size 33. I replaced my whole wardrobe and had a lot of fun doing it.

Your skin will adjust somewhat after surgery. This will happen in the first year. Beyond that, plastic surgery is the primary option. I am 65 years old and for the most part this problem did not bother me. The exception was in my face. It became so wrinkled that it began to look like crinkled paper. Overnight, I began to look like I was 100 years old. My wife said to use Bio-Oil (available in CVS) on my face and this corrected that problem.

Chefchrisp

It has been a month since your surgery. How are things going for you?

My wife was the one who urged me to undergo this operation and she has been supportive. The only person who has not been supportive has been my mother. She is somewhat dependent on me and is more focused on anything that might interfere with that support.

When my blood work came back from the 6 months post-op testing. It showed that I was Iron deficient. They prescribed additional Iron supplements which I have since started to take. Even though I had 2 hour separated between iron (in Flintstone vitamins) and my Calcium supplements, I suspect this was the problem area. I had started to drink milk as part of my Protein drinks and I suspect the Calcium in the milk was causing the iron deficiency. So I moved all my iron supplements to the end of my day; just before bedtime. I should have the next batch of blood test results soon.

I agree with what the others are saying. Look at reducing some of the Protein bars and shakes. I am 11 months post op and achieved my weight loss in 7 months. I lost 20 pounds pre-op and 80 pounds post-op for a total of 100 pounds. (I had a RNY which is known for its rapid weight loss.) I now weigh 160. Part way through the process my weight loss went into a standstill. I looked at my caloric intake and decided at the time that I was getting so little Protein in my meals, the problem must lie in the protein supplements. So I dropped from 3 Protein Shakes a day down to two and I began to loss weight again.

As the volume of my meals went up, I was able to derive more protein from my meals. Presently, I think I am consuming around 50% of my protein requirement from my meals. This means that I can reduce the amount of protein supplement I am taking. When I hit my bottom weight, it allowed me to experiment. So I completely went off my protein shakes. Today for my protein supplement, I have one large cup of hot cocoa (Nestle "No Sugar Added") in the morning and one homemade large berry smoothie in the afternoon.

I have discussed my meal plan in "How I survived Bariatric Surgery" which is available at http://www.breadandbutterscience.com/Surgery.pdf

I am 11 months post-op and have not experienced any problems with infections. The surgery placed many other medical problems that I had into remission, so I am pleased by the results.

A study lead by Dr. Anita Copurcoulas, researched 1700 patients, three years after surgery and reported the results. Here is a link.

http://acsh.org/2013/12/weight-loss-surgery-effective-severely-obese/

I had gastric bypass surgery 11 months ago. I tell everyone. Even strangers walking on the street. In general, most reactions fall into two categories - either supportive or curious. I only have one person who is negative and I ignore their comments. From my perspective, I want this operation to succeed. In a sense, I want to put myself on report. I want to own this decision. I want a thousand eyes on me, so that I am not tempted to fail.

Sorry to hear about your problems. I had a RNY 11 months ago. I choose this method because it had the lowest rate of revisions. If I undergo surgery once, I do not want to repeat this process ever again. In my Support Group meetings, I have meet several people who had lap bands that then underwent RNY revisions. In one case, the individual sustained damage to his stomach because the band moved back and forth and eventually started to wear away his stomach. In another case, the woman had the band installed too high, which caused her to be unable to eat even the smallest portion of foods. This then lead to all of her teeth falling out due to lack of nutrition.

Chelseabell91

Well a month has now transpired. How are you doing. Has your weight fallen since you started this thread.

I am 11 months post-op. I bottomed out on weight loss at 6 months. As the volume increased in my meal plans, I was able to pull almost half of my Protein from my meals. This allowed me to be a little creative on my Protein supplements. I transitioned from protein shakes to a large cup of hot cocoa ("no sugar added" Nestle) in the morning and a berry smoothie in the afternoon.

I am 11 months post-op. It took me 6 months to get to my happy state. I experienced a lot of little issues along the way. I noticed that the skin in my face began to wrinkle really bad. It was like paper thin crinkles and it made me look like I was 100 years old. My wife suggested that I try Bio-Oil available at CVS. I put it on my face each morning when I get up and that takes care of the wrinkles. I really didn't know how much fun it would be buying new clothes before the surgery. Anyways, just here to tell you there is light at the end of the tunnel.

I am sorry to hear that your surgery went bad. From discussions in my support group meetings, I have been told that the gastric bypass surgery today is very different from the surgery performed two years ago. Today most of the surgery is done laparoscopically (also called minimally invasive surgery (MIS)), where before it was done as major surgery. As a result many of the problems that occurred years ago do not occur today. I had my surgery a year ago and saw none of the problems that you report. The surgery was even less involved than the laparoscopic hernia operation I had a decade ago. I did not take any pain medicine after the operation and none since.

Thank you James for your response, that was very informative. I have pretty consistent heartburn now.

Do you find your tastes have changed a lot since surgery?

Right after surgery, almost everything tasted bland. But now since I am 11 months post surgery, food has flavor again. But then again, I am eating high Protein chili and high Protein Soups which are full of flavor. This approach may not be the norm but it works for me.

Irrespective of what is on the sheet you received, you need to obtain the proper amount of Protein each day. Protein deficiency, when continued over a long period of time, can cause a disease known as protein calorie malnutrition (PCM). The common symptoms of PCM are: poor healing, hair loss, muscle loss and lack of energy.

In the early stages right after surgery, your meals are so small that you are unable to obtain the proper amount of protein from meals alone. That is why individuals that undergo Gastric Bypass Surgery rely on protein shakes, protein bars and other protein supplements.

I don't know if I can answer the original question about how far you can push it. There is one individual in our area who is called Chef Woody. He was a Chef as an occupation and after surgery he decided to create meals designed for those who went through Bariatric Surgery. He was probably as old as me (age 65) and he got into exercise in a big way. His passion was bicycling. In a competition, he rode across the state of Indiana from end to end in one go. When he reached the finish line, he had no energy left. He couldn't even physically move. So I think you can push it pretty far.

"Do I need to cut back a little bit on the activity?" I don't know. You started out at 234 pounds on January 2014 and you have dropped 42 pounds since then. That is a good weight loss but you are still in the middle so you still have many fat cells that can act as a cushion or buffer. I would not recommend holding to 900 calories per day when you have reached your bottom weight, especially since you are exercising a lot.

My doctor recommended between 75-90 grams of Protein daily. At the beginning, this will come from your Protein supplements (protein shakes and protein bars), because the volume from your meal plan is so small, you can't pack much protein into it. For me Muscle Milk Light (vanilla Creme) worked well for the Protein Shakes and QuestBar worked good for the protein bars. I normally use protein bars when I am up and about and unable to haul my blender around to mix a Protein shake.

I am now 11 months post-op. I reached my bottom at month 6. At bottom, my goal is to maintain my weight loss rather than lose weight. Therefore my focus is different. I can allow a few extra calories in my diet. My meals provide me with about 50 percent of my protein requirement. My protein supplement consists of one large cup of hot cocoa ("no sugar added" Nestle) in the morning and a large berry smoothie around dinner time.

The protein supplements do not count against your meal plan volume limits. It took me a while to understand this.

When you said, "I was told protein first when it comes to eating". I hadn't heard this before. I have heard that it is important to eat your protein supplement prior to eating your meals. The rationale is that protein helps take away your hunger so therefore you will not be tempted to overeat.

When you said, "The only thing I know is I'm not supposed to have protein shakes after week 2...and I'm in week 4. They say they discourage the use of liquid calories after week 2" That is very strange. How are you suppose to get in your protein requirement without a Protein Shake. I have heard that they do not want you to drink liquids with your meals. But that is a meal requirement. But cutting out protein shakes after week 2 does not make any sense.

I choose gastric bypass over other types of weight loss surgery because it had the lowest rate of revisions. If I go through the surgery once, I never want to go through it again. It also produces the most dramatic weight loss and the weight drops off the quickest. I also had acid reflux before surgery. One of the drugs they prescribed for me for the first year after surgery was Omeprazole (which can be bought over the counter as Prilosec), which is for acid reflux. They prescribed it to promote the healing of my stomach. I think that is routine. Anyways I am 11 months post-op and heartburn has not been a problem. As far as dumping caused by overeating, yes it can be a problem. But before you hit the dumping stage, your body warns you that you are reaching your limit.

I also had an addiction to sweets prior to surgery. But I stay away from them now. I try and limit my intake of processed sugar and opt for synthetic sweeteners. But sometimes by accident, I do consume greater levels of process sugar than my body wants. It seems that my reaction to this is not dumping but rather diarrhea and a bit of stomach ache.

I noticed that after the surgery, I was lactose intolerant. This lasted for a couple months and then went away. But having diarrhea is a sign for being lactose intolerant. If this is the cause, it will restrict the choices for your Protein supplement. You cannot use milk. I used Muscle Milk Light which I blended with Water and a half a banana. This product is Lactose Free. I preferred vanilla Creme but that's a function of taste.

My starting weight was 260 pounds [118 kilograms]. I lost 20 pounds [9 kilograms] pre-op and 80 pounds [36 kilograms] post-op. I am now at 160 pounds [73 kilograms].

When I hit week 9 after surgery, I had all the ingredients to be able to eat chili. It met the basic requirements for Protein, vegetables, and starches. It was good tasting. Once I made a pot of chili, I would eat 1/3 cup at each meal and I was good to go. At 11 months out, I still do this but I am now up to 3/4 cup and I have added high Protein Soups to the list to give me some variety. I have included the recipe of these on my webpage if you care to try it.

At month 4 after surgery, the meal plan adds fresh fruits and vegetables as a daily snack. So at night before bedtime, I eat a couple apples with the skins because it helps with Constipation, and sometimes an orange or grapes.

This is my basic food plan and there are many days when I am up and about, so I deviate from my plan. I eat at restaurants, even fast food restaurants. I try things. I experiment. I have a good time. If my weight goes outside the range 160.0-162.0, I return to the basic menu and my weight falls back in line. I entered my bottom at 7 months after surgery and I have remained there ever since. I weigh myself each morning. Quick positive/negative feedback. I look at the whole process as getting to my happy state. In my case, I got to my happy state at 6 months after surgery and have been there ever since.

The daily Protein requirement is a combination of the Protein that is eaten in meals combined with the protein obtained through protein supplements (for example protein shake). At the beginning because the meal volume is so small, you will be consuming very little protein in meals but as time goes on this will increase and become important. I tried to stay within the 75-90 g/day range. When I hit a plateau early and my weight loss leveled out too soon, I reduced my protein intake slightly. I went from 3 protein shakes per day to 2 per day. I reasoned that since I was dissolving fat cells, I had a buffer. But today at 11 months out, and because I have reached my bottom weight, I try to meet this protein requirement. Around half of my Proteins come from meals and the other half from protein supplements.< /p>

One of the things that I didn't understand at first about the process was that the meal plan requirements was a separate category from the protein requirements. So even though the volume is very limited on the meal side of the equation. It is not on the protein side. Volume doesn't count on the protein side. At the beginning after I had surgery, I was focused on very concentrated forms of protein supplements. These are generally called Protein Shakes. But now since I have reached bottom, I can change focus and look at making this work for me. I hate the taste of most protein shakes. So because I am at the bottom and because I can afford to consume more calories now, I choose to take one of my protein supplements at night in the form of a berry smoothie. This is almost as good as having a large milk shake each night. It has a large amount of fruits topped off with good tasting Greek Yogurt blended together, no sugar, great nutrition. It is the equivalent of 3 cups of food but doesn't count against my meal plan. It gives me 14 grams of protein which isn't a lot but at my stage, I am pulling in half of my protein requirements from meals. Did I mention this taste really good. It contains 300 calories but at my stage, I can afford it because I am focused on maintaining weight not losing more weight. Keeping me in a happy state.

Wow! There is a world of difference in the Vitamin regime between the U.S. and Australia for individuals that undergo Gastric Bypass Surgery. I am not saying who is right and who is wrong, but if you begin to experience major health issues, the problem may lie in your Vitamin intake.

The following is the regime that I have been directed to take.

1. Three Flintstone's chewable Multivitamins daily. (These contain my Iron requirement and I am taking these late at night to provide a 2 hour separation between my Calcium intake.)

2. 1500 to 1800 milligrams of calcium citrate. (This is my Calcium requirement. I take Citracal. These are large pills and at the beginning I had to smash these pills because I couldn't swallow them whole. For best absorptions, I take these in 3 doses of approximately 500 mg spaced two hours apart.

3. 5,000 I.U. of Vitamin D3 daily.

4. 500 to 1,000 micrograms sublingual B12 daily or injection once monthly or Nascobol nasal spray once weekly. (I do the B12 injections once per month and my wife gives me these.)

5. 100 milligrams vitamin B1 also known as Thiamine daily. (At the 6 month mark, my doctor reduced the dose down to one vitamin per week.)

A cup of food per meal at your stage (6 weeks after surgery) will probably bring your weight loss to a grinding halt. But let me switch to another subject - Vitamins. What Vitamins are you taking? Perhaps if they did not prepare you for the surgery by giving you a meal plan, they may have also been remiss in defining Vitamin requirements.

In a gastric bypass operation. They cut your stomach in two. Your normal stomach which processes your food is now very, very small. One of the functions of a stomach is to provide your body with nutrients. Some of these nutrients are vitamins. Without certain vitamins, you will develop serious medical problems. Therefore there is a regiment of vitamins that you need to be taking in order to avoid a trip to the emergency room. Your body no longer synthesizes these. What vitamins were you directed to take?

Let's see! At Week 5-8 after surgery, the meal plan recommended to me was:

Breakfast: one ounce of Protein + 1 ounce of fruit

Lunch: one ounce of Protein + 1 ounce of vegetables

Dinner: one ounce of protein + 1 ounce of starch

All of this food should be pureed. One ounce is equal to 2 tablespoons or 1/8th of a cup or 28 grams or 28 milliliters. This is a microscopically small amount of food. At this stage, you are essentially surviving on Protein shakes, Water and Vitamins. They recommend your daily protein intake should be between 75-90 grams of protein per day. This is important. Also you need to drink 64-80 ounces of low calorie fluids daily. That would be 1.8 - 2.3 liters per day. You move to solid foods at Week 9.