James Marusek

The most important things after surgery are meeting your Protein, Fluid and Vitamin daily requirements. Meals are secondary because your body is converting stored fat into the energy that drives your body. Thus you lose weight. Exercise is also important. Weight loss after RNY surgery is driven by meal volume control rather than caloric restriction. This article describes my experience with RNY gastric bypass surgery during the "Weight Loss" phase. There are recipes at the end. http://www.breadandbutterscience.com/Surgery.pdf It's strange that you were not given meal volume limits as a function of weeks/months post-op prior to surgery. My guidelines started me out at 4 tablespoons (1/4 cup or 2 ounces) per meal for the first 8 weeks following surgery and slowly increased that to 16 tablespoons (1 cup or 8 ounces) at 1 1/2 years post-op. At 4-6 month post-op, my meals were limited to 8 tablespoons (1/2 cup or 4 ounces) per meal.

Be honest. They are only there to help.

It depends quite a bit on the insurance that you have. For me it took around 9 months from initial consultation until surgery.

I am 35 months post-op RNY gastric bypass surgery. This article describes my experience with the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

It slowly gets better. I reached my happy state at 6 months when all the problems both big and small seemed to melt away.

The most important requirements after surgery is meeting your daily Protein, Fluid and Vitamin requirements. food is secondary, because your body is converting stored fat into the energy that drives your body. Thus you lose weight. There are several different types of surgery (RNY gastric bypass, gastric sleeve, lap band, and duodenal switch to name a few). The type of surgery will also dictate when you are able to consume solid foods. So don't be too concerned that you have not yet reached the solid stage. I had RNY surgery and I found that softer foods such as chili and Soups went down much easier than hard foods such as steak. They became my mainstay. I have included a few recipes for high protein chili and soups at the end of a short article about my surgery. Here is a link. http://www.breadandbutterscience.com/Surgery.pdf

I think it is common for individuals that undergo weight loss surgery to not be able to see the weight that they have lost. Before surgery, I never really, really looked at myself. I was never in photographs because I was the photographer of the family. When I looked in the mirror, it was always a straight shot, which minimizes a visual of my obesity. I think it is very important for someone who is about to undergo surgery to take a self portrait prior to surgery and then once the weight comes off. A side-by-side comparison photo is the best way to appreciate the weight loss. I took one before and one at 6 months. It was a brutally honest photograph and I tried to strike the same pose before and after. Here is a link. http://www.breadandbutterscience.com/Operation.jpg

I had RNY gastric bypass surgery whereas you had gastric sleeve. I take a lot of Vitamins and will do so for the rest of my life. But only one of my vitamins was a chewable. I was also told do not use the gummy vitamins. So you may want to check with your nutritionist before you make that change. After surgery, I lost the ability to swallow anything medium to large, so most of my vitamins either had to be split or crushed in order to swallow them. After about 2 months this problem went away and I regained my ability to swallow. From my perspective all Protein shakes taste terrible. But after surgery I had to take them because the protein that I consumed from food was so minuscule that my body would be damaged if I didn't. Your protein daily requirement is met by a combination of the protein obtained from protein supplements combined with the protein from meals. As my meal volume increased (over the next 1 1/2 years), I was able to decrease my reliance on Protein Shakes because I concentrated on consuming high protein meals. I went from 3 protein shakes a day, down to 2, then down to 1 and finally none. The important point here is you don't have to like your protein supplement; you just have to tolerate it. I used Muscle Milk Light (vanilla Creme) blended with Water and added a half a banana to give it better flavor.

I basically told everyone about my surgery, even strangers on the street. Almost everyone was supportive or curious. I had only one person react badly and that was my mother. In her case she is elderly and depends on me for personal support. She viewed the surgery from the perspective of someone who did not want to experience the possibility that anything could threaten that support.

I am sorry to hear of your loss. I will pray for you.

Your weight was probably right between two weights when you measure it. Any little thing can cause the reading to fluctuate. Such as wash your face with Water. Take a Vitamin. Or even the way you step up on the scale. Generally I use a scale that provides readings in 0.2 pound increments. It is repeatable. If it is not repeatable then get rid of it and get a better one. Also check your batteries if its electronic.

I basically told everyone even strangers on the street. The reaction of most people fell into two categories. They were either supportive or they were curious. Some people are very guarded. I believe it has to do with their past dieting history. First they tell everyone they are going on a diet. They lose some weight. Many people congratulate. Then they get off the diet and gain the weight back and then some and they fell like an abject failure. So I think they are guarded because they equate their expectations from surgery similar to that of dieting.

There is some recovery time after surgery. I suspect that if you went to class 4 days after surgery, you would probably regret it and not get much out of the class. But at 4 days + 1 week, you might fair much better provide it was't an all day thing.

What I experienced after RNY gastric bypass surgery was very different than dieting. After surgery, I completely lost my hunger. It was not hard losing weight when hunger is not constantly continuously gnawing at your bones. I am 35 months post-op and I am happy. There are two phases after weight loss surgery. There is the "Weight Loss" phase and the "Maintenance" phase. I also have a sweet tooth. In the following article, I describe my approach to satisfying my sweet tooth. http://www.breadandbutterscience.com/Surgery2.pdf

After RNY gastric bypass surgery, the three most important daily requirements are Protein, fluids and Vitamins. After surgery your taste buds change and Protein shakes can taste very nasty. It is important that you find a Protein shake that you can tolerate, you don't have to like it, only tolerate it. So keep experimenting. There are many types available. I used Muscle Milk Light (vanilla Cream) powder with Water. I blended in a half a banana to give it some taste.

Weight loss after RNY gastric bypass surgery is achieved by meal volume control. The volume of meals are incredibly small at the beginning. So therefore you need to consume Protein otherwise your body will begin to break apart. That is why you have to supplement your protein intake with protein supplements (protein shakes). But your protein requirement is met by a combination of the protein you consume from protein supplements combined with the protein from meals. If you concentrate on consuming high protein meals, then as your meal volume increases you will be able to reduce your reliance on Protein shakes. Over a year and a half, I went from 3 protein shakes a day, down to 2, down to 1 and then finally none. Part of what you may be missing at this stage is your need to chew. It is an automatic function that is related to the eating process. So when you reach the solid food stage, this need will begin to be satisfied. When you get to the solid stage, you may find some foods too hard to eat such as meats. I found that softer food went down easier. Softer foods are really a function of preparation. These are chili and Soups. They were my mainstay. After surgery, foods lost their flavor. By mixing food groups together, I found they helped to restore taste again. I have included a few recipes in the following article at the end once your reach that stage. http://www.breadandbutterscience.com/Surgery.pdf

Congratulations on your weight loss thus far. I look nothing like my driver's license photo anymore. Whenever I pay by check and they ask to see my driver's license and I show it to them, I look to see if they will notice the difference and challenge me. But so far, it just seems like an automatic response. I am 35 months post-op and this year I have to renew anyways. So I will just wait.

There are different types of sugars. There are the natural sugars found in milk and fruits and then there is the processed high calorie sugars found in table sugar, high fructose corn syrup. You need to stay away from the processed sugars. After RNY gastric bypass surgery, the part of your body that process refined sugar and fats has been cut away, so if you consume a significant amount it can lead to dumping syndrome. After about a year, your intestines will figure out this anomaly and will adapt and begin to process this type of foods. Therefore your tolerance to this type of food will change over time.

I had RNY gastric bypass surgery 35 months ago because I had a number of health issues settling in (diabetes, high blood pressure, sleep apnea, severe acid reflux [GERD]). I saw what these conditions did to my mother and I resolved that I would not walk down the same path. Within a couple weeks after surgery, all these conditions went into remission and stayed there. So I am well pleased with the decision. Dumping syndrome is actually a good thing. You have warning signs that you can detect prior to going into dumping syndrome. There is many a time when I have these warning signs and just immediately just stop eating my meal. It is an automatic trigger. Because I know that if I eat another bite, then I will experience dumping syndrome and I don't want to be there.

Does your current insurance cover band fills now? I am not a fan of Lap-Band. More people are having them removed than putting them in today. One of the individuals in our bariatric support group meeting had a revision from lap-band to RNY gastric bypass because the band wore into his stomach and it was about to rupture. Health insurance can be difficult. But sometimes you need to play along. Said I haven't used my band the way I was supposed to and didn't have enough follow up care. So follow their advice. Sounds like that is what you are doing (and document it). And see what happens. But also keep the pressure on. GERD is a bad sickness and can lead to other big problems. If you do get surgery, RNY gastric bypass is the type to shoot for, since Sleeve will only make GERD worse.

78 pounds in 4 months is fine. Don't worry about losing weight too fast, your body will determine your rate of loss. You should probably lay off the bread. You will be in the "Weight Loss" phase for only a short time and then you will transition into the "Maintenance" phase. So you want to maximize your weight loss in the "Weight Loss" phase as much as you can and that means minimal bread consumption. After RNY surgery, I went from a size 46 down to a size 32 in short order and from a size 3X in shirts down to a size Small. That was simple amazing. Again not a bad thing. I am 35 months post-op now and maintaining the weight loss. It means that I can buy clothes from department stores again. Chili at Wendy's and a taco at Taco Bell is not nutritiously bad food. And when I am out and about that's what I go for. But wait until you have transitioned past the "Weight Loss" phase. The time you are in is very precious, don't waste it.

All three seem to be O.K. Over 20 grams of Protein, low sugar. But the important thing is to find one that you can tolerate. For some types of WLS, you taste buds may change radically. So you might want to wait till after surgery to make your final selection. You don't have to like the taste of Protein shakes but you absolutely have to be able to tolerate the type you finally select.

There is a lot of information in the booklets and you need to know this info. Do you have anyone to help you. Perhaps they could read this for you. You might ask your surgeon if they have the information in electronic format. I suspect once you capture this media electronically, you will be able to manage on your 42 inch monitor.

I am 35 months post op RNY gastric bypass surgery. This article describes my perception of the "Maintenance" phase. http://www.breadandbutterscience.com/Surgery2.pdf

Congratulations on your first milestone.