James Marusek

Congratulations.

After you leave the "weight loss" phase, you will slide naturally into the "maintenance" phase. For me this occurred at around the 6 or 7th month post-op. But it will vary by individual. This article describes my approach in the "maintenance" phase. http://www.breadandbutterscience.com/Surgery2.pdf

I had RNY gastric bypass surgery because my overweight condition over the years led to a number of health issues including diabetes, high blood pressure, sleep apnea, severe acid reflux (GERD) and others. I had the surgery 35 months ago and all these medical conditions went into remission within 2 weeks after surgery. I was off all the meds. And more importantly they stayed in remission ever since. So I consider this to be one of the better decisions which I ever made.

After surgery, you body is converting stored fat cells into the energy that drives your body. Thus you lose weight. After surgery, I didn't detect much of a change in my energy levels but some people do. Some people become more active, others seem to go in the opposite direction. After RNY surgery they make your pouch smaller so that you will be unable to consume much volume. If you try, you will likely experience dumping syndrome and that can be a very unpleasant experience.

In general, RNY gastric bypass is recommended over sleeve for patients suffering from severe acid reflux. This is because the sleeve will only make the condition worse. I knew one person personally who went from band to bypass. In his case the band was wearing into his stomach and his stomach was about to rupture. I don't think you will incur any more risk because you have a low BMI in getting a revision from band to bypass. I suspect that in reality, the risk will be much less. In the case of the individual that I mentioned, because there was scare tissue from the band removal, then they rerouted his stomach, his pouch was a little smaller than most operations. But he was fine with that. It just meant that he had to consume a little less food during his meals.

After surgery, your body begins to break down the fat cells in your body. Within these fat cells are also stored chemicals and hormones. Thus as you lose weight you can get a flush of emotions. This will get flushed through your kidneys and expelled in your urine but you can still feel the effects while you are in the "weight loss phase". For this reason it is important to drink a lot of pure Water so that you body can flush these from your system. You might focus on using filtered water rather than tap water.

I had cramping followed by diarrhea after RNY surgery. I became lactose intolerant. Anytime I consumed milk or anything else that contained lactose (some Protein drinks contain lactose), I had an immediate problem. This condition went away after a couple months.

It is common to hit stalls along the way. The primary requirements after surgery are meeting the daily Protein, Fluid and Vitamin requirements. Exercise (around 30 minutes of walking each day) is also important. So just be a little patient and let the magic happen.

I had severe acid reflux (GERD) and that was the main determinant on why I had RNY gastric bypass surgery. The sleeve will only make this condition worst. Also gastric bypass had one of the lowest revision rates. If I went under the knife once, I sure didn't want to do it again.

Actually I was up and walking within 3 hours after surgery. When I was in the weight loss phase, I walked 30 minutes per day, every day for a year. Since you have a bum knee, Water aerobics would be good for you. I would think that you could start relatively soon after surgery. Just give you sutures a little time to heal and if you have a port wait until they remove it and that heals. You might consult with your surgeons office for the go ahead.

After surgery, I became lactose intolerant. Whenever I drank a glass of milk it resulted in stomach cramps and diarrhea. So I quickly learned to remove milk from my diet. Some Protein shakes contain lactose. So you might want to read the labels. This condition disappeared after about 2 months and from that time I have been able to drink milk again. The most important things after surgery are to meet you daily protein, Fluid and Vitamin requirements. So concentrate primarily on those requirements. food is secondary because you body is converting your stored fats into the energy that drives your body. Thus you lose weight. If you want to maximize your weight loss then it is also important to walk about 30 minutes each day.

The three most important requirements after RNY gastric bypass surgery is to meet your daily Protein, Fluid and Vitamin requirements. food is secondary because your body is converting your stored fats into the energy that drive your body. Thus you lose weight. It is also important to get 30 minutes of walking in each day to maximize your weight loss. This is my experience with the "Weight Loss" phase. I have included some recipes at the end of the article. http://www.breadandbutterscience.com/Surgery.pdf

I am 35 months post op RNY gastric bypass surgery. Right after surgery I became lactose intolerant. So I had episodes of diarrhea until I figured this out and stopped drinking milk. Then several months after surgery, I had very severe constipation. The only thing that worked was glycerin suppositories that you had to insert up your rear end. I finally discovered eating apples with the skin helped solve my problem. So generally constipation is not a problem anymore. It is also very important to consume the adequate amount of fluids each day otherwise it can lead to constipation.

Recent research seems to point to Electro-Stimulation with Exercise as optimizing caloric burn. I am not much of a fan of exercise for exercise sake. Seems like a waste of my precious time. I tend to rely of the physical exercise of manual labor. It seems more productive to me. For example I was out this morning cutting up some large trees that had fallen over my road. But for those who are exercise enthusiasts, I thought I would provide a glimpse of some of the latest research. I guess I would also like to ask the question, has anyone in the WLS community actual done this type of exercise? Weight-conscience Americans are always looking for ways to increase their metabolic rate, since a higher level equals increased burning of calories. Researchers at the University of Granada believe they’ve found an effective formula, using electro-stimulation, that will not only increase caloric burn, but also help improve performance. However, researchers caution that this type of training should be used in tandem with traditional exercise, and not as a substitute. Scientists assessed 262 individuals after a bout of high-intensity interval training (HIIT) followed by a session of electro-stimulation and found that when combined, the training generated up to 30 percent higher calorie burn than aerobic exercise alone. Additionally, those who engaged in HIIT plus electro-stimulation experienced increased metabolism in the following days. Specifically, researchers found significant differences in basal oxygen consumption at 60 minutes and 24, 48 and 72 hours after the workout. The group also showed higher levels of lactate concentration in the blood (15.6 mmol.L–1) than after aerobic exercise (2 mmol.L–1) — evidence to support HIIT and electro-stimulation as a viable training stimulus. Physiology professor Angel Gutierrez Sainz is strident proponent of this approach to training, and insists that 20-minute weekly sessions of HIIT with electro–stimulation “offers extraordinary neurological, metabolic and functional advantages for sedentary people as well as elite athletes suffering from an injury and athletes in training.” Electro-stimulation has been making headlines in recent years, as it has been previously shown to induce increases in energy expenditure similar to that of exercise. A 2013 paper in the journal of Applied Physiology Nutrition and Metabolism showed that one hour of electrical stimulation increased heart rate, resting energy expenditure and carbohydrate oxidation above resting levels and at slow walking speeds less than 6 km/h. The method might also improve muscular strength and aid in rehabilitation. In a paper published in Physical Therapy, researchers randomized 20 patients recovering from ACL knee surgery. Ten individuals were assigned traditional strength training exercise five days a week for three weeks. The other half was assigned to an electrical stimulation regimen. Results showed that the electrical stimulation group showed higher muscular strength after the three weeks. The results indicate the technique, researchers claim, should be prescribed as a post-operative rehabilitation. The results of these three studies have important health implications and suggest that electro-stimulation can be used as a supplement in overweight and rehabilitative populations, to further induce effective cardiovascular, neuromuscular and muscular strength adaptations to physical exercise. While this method is attracting followers, it’d be prudent to check with a physician or health professional before engaging in the combined procedure. And certainly don’t rely on electro-stimulation alone in any attempt to induce weight loss. http://acsh.org/news/2016/04/16/electro-stimulation-with-exercise-ups-caloric-burn-study-says/

At times there can be a lot of stress associated with weight loss (especially when dealing with the health insurance companies or from the comments from co-workers). One way to relieve that stress is grown-up coloring books. Experts speculate that the rhythmic repetition of coloring helps tune out the outside world, which in fact releases stress. But, they quickly note, the moment of zen is not meant to replace actual therapy when needed, because of the relationship that’s established between a therapist and the patient. The American Art Therapy is behind the craze, too, releasing a statement saying it supports the use of adult-coloring books for “pleasure and self care.” http://acsh.org/news/2016/04/16/feeling-stressed-out-adult-coloring-books-can-help/

Congratulations on your 103 pounds of weight loss. This article discusses my experience with the "Maintenance" phase. http://www.breadandbutterscience.com/Surgery2.pdf

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

The rate of loss is also dependent on the type of surgery.

After RNY gastric bypass surgery, your weight loss is achieved through meal volume control. At 2 weeks post op, that is an incredibly small amount of food. So although you may be use to counting calories, you might not focus on those at the moment. The most important elements after weight loss surgery is 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. Walk around 30 minutes each day or equivalent exercise. Follow the meal volume guidelines. The part of the stomach that processes fats and sugars has been cut away. Therefore if you consume this type of food, it will get dumped into your intestines and can lead to dumping syndrome. After about a year, your intestines realize something has happened and physically adapts and changes to absorb this type of food. Therefore when you are about a year out, it is not so important. But sugar and complex carbs should probably still be limited otherwise the weight that you lost might start to come back.

I think it is extremely important to maximize your weight loss during the "weight loss" phase. So I would recommend waiting at least until you hit the "maintenance" phase. I am 35 months post op RNY and I limit my complex carbs (bread and pasta) to a maximum of one meal per day.

Avoid the temptation of getting too stocked up. First your taste buds may change after surgery and therefore you may dislike it after surgery. Secondly, you meal volume size is so incredibly small, you will not be eating very much.

Congratulations.

Sounds normal. If you get to a point where you are unable to drink fluids or consume any food, it is probably a sign of a stricture. But I don't think you are there.

Try to walk 30 minutes per day before and after surgery. It really does reduce the gas pain and surgery pain. It makes the recovery process go smoothly. When you are in the hospital try to get up and walk every 2 hours. It minimizes the gas. I took no pain medicine after I left the recovery room in the hospital after RNY surgery. I didn't need any because my pain level was so low.

Protein is critically important after RNY gastric bypass surgery. In the beginning normally this is in the form of Protein shakes. I hated almost all forms of protein shakes after surgery. But I drank them even though I hated them. You don't need to love them, you just need to tolerate them for awhile. I found that if I blended in a half a banana into the Protein shake it tasted better. I used Muscle Milk Light (vanilla creme) Protein Powder blended with Water. Also if you can tolerate milk, you can add some protein to your diet that way and also meet part of your daily Fluid requirements. When you get to around the 6 month mark, you will be able to begin using Protein Bars. I found Quest bars to be rather good. The protein shakes requirement does not last forever. As your meal volume increases, if you concentrate on eating high protein meals, you will be able to begin to drop off the protein shakes. I went from 3 protein shakes a day, down to 2, down to one and finally I completely went off the protein shakes when my meal volume limit became 1 cup at 1 1/2 years post-op. [Your daily protein requirement is met by a combination of the protein from supplements combined with the protein from meals.]