James Marusek

For the first year after RNY surgery, the body does not process fats and sugars. That part of the stomach has been cut away. Therefore if you take more of these than you should it can lead to dumping. A can of Carnation Evaporated Milk contains about 24 grams of fat and 36 grams of sugar. A can of Carnation Condensed Milk contains about 30 grams of fat and 47 grams of sugar. Way too much post-op RNY. Then again maybe you are talking about Carnation Breakfast Essential powder, which really does not have very much Protein compared to other protein powders, so I wouldn't really call it a Protein Shake.

Generally your body warns you prior to reaching dumping syndrome. As you eat a meal, the food will taste good. Then after several bites you find that the food becomes revulsive. Also you may develop other symptoms for example I experience hiccups or my nose begins to drip. Whenever I reach this point I stop immediately because if I take one more bite it turns into full dumping syndrome. So watch for the clues. Others on the board may chip in and talk about their symptoms just prior to reaching dumping. Its and interesting subject.

For me the cost of the extra Vitamins are offset by the negative cost of the prescription medicine that I took before surgery and now no longer need. I also shop for lower prices on vitamins such as "buy one get one free sales" at local drugstores or using generic brands. For me the cost of Protein supplements (Protein shakes, protein bars) were significant. But as my meal volume increased, I concentrated on consuming high protein meals and as I reach 1 cup per meal, I have completely taken myself off supplements because I was able to meet my protein requirements on meals alone. It may be difficult to take vitamins at the beginning because of the inability to swallow. As a result I had to crush my calcium tablets and that tasted very bad. But after a couple months my ability to swallow returned and things went down much easier. Some people chose vitamins based on taste. This is especially true on calcium supplements. But that approach can costs more. I just endure with the inconvenience.

Congratulations.

Can you elaborate? My first semester in college was in the year 1965, that was a half century ago. What you are experiencing right now is typical for many college students. Several months of non-stop stress followed by a few weeks break and then back to the grind. The few weeks break is a recovery time. Soon you will undergo gastric sleeve surgery. You will need to buckle down and follow the directions and requirements of this program if you will see and maintain significant weight loss. But you are not there yet. If you are in a pre-op diet, you should follow those requirements.

Being a full time caregiver can easily drain you. Sometimes you just need a break to recharge your batteries. Recently I began experimenting with the medicinal properties of essential oils. Some of the formulas work and others don't, so its a little bit hit and miss. But the following is a formula for bipolar disorder per Dr. Scott Johnson. It is not recommended to replace her current medical treatment only supplement it. This is to be applied topically (to the skin) not orally. Apply 1 drop each of frankincense, cedar wood, sandalwood, spruce and lavender essential oil to the base of the skull and behind the ears (2 to 4 times per day). Apply 2 or 3 drops of helichrysum essential oil over the liver (1 to 3 times daily). Apply 5 drops of orange and 2 drops of lemon essential oil to the bottom of the feet (3 times daily). If I was going to experiment with the oils, I would probably add a drop of Passion Flower essential oil to the first one at least once per day.

I am not a doctor either but when you look at the printout, there are several columns. The column on the left is Test Name. For example if you search using google on the words "Hgb" and "bloodwork", it will give links to a number of websites that describe this test and what it means. For example https://labtestsonline.org/understanding/analytes/hemoglobin/tab/test/ The column on the right is called Reference Range, this gives the values that you should have. The next column is the one in the middle, which is called Out of Range. If you are outside the range of normal, then your readings will appear here. It will have a (L) if you are on the low side and an (H) if you are on the high side. The numbers are good to look at and compare with the reference range because it can tell you how far you are away from normal. On your particular lab results, if you are extremely on the low side, they used (L!) After RNY gastric bypass surgery, your body can no longer synthesize the Vitamins you need from processing foods, that part of your stomach has been cut away. Therefore it is mandatory that you take vitamins for the rest of your life. You are very low on Hgb which means you need to supplement your Iron intake. In my case I am low in iron and I take a 65 mg Ferrous Sulfate supplement each day. Since iron and Calcium supplements don't mix, it is important to take these at least 2 hours apart. In my case I take my iron supplements just before bedtime. I take my calcium supplements throughout the day and also drink milk which contain calcium, so nighttime was the best time for me to take my iron.

Congratulations.

In the Weight Loss phase after RNY surgery, losing weight is a function of meal volume control. You consume very little food (2 ounces) per meal and eventually over 1 1/2 years work your way up to a cup per meal. So if you really want to lose the weight, it is extremely important to follow the program requirements. The most important requirements are meeting your daily Protein, Fluid and Vitamin requirements. Meals are less important, provided you do not exceed the volume requirements and do not go overboard with Snacks. This is because your body is converting stored fat into the energy that drives your body, thus you lose weight. Exercise is also important during the first year. You should be getting 30 minutes of exercise per day. Otherwise it will limit your success with the program. I am not one for exercise because it seems like wasted effort. Rather I prefer manual labor instead. It seems far more productive to me to split a rick of firewood than to drive a half hour to the gym to do 30 minutes of exercise. Anyways physical labor can count towards your exercise requirements. If you go to the mall and go shopping walking from store to store for 2 hours, that can count towards your exercise. I am not sure how much weight you lost and whether you are happy with the weight loss. But a 2 month plateau might mean that you are entering the "maintenance" phase. Provided you are meeting your daily protein, fluid, vitamin requirements, one method that might kick-start your continued weight loss again is to examine your daily protein. Your protein requirement is met by a combination of the protein you obtain from meals combined with the protein from supplements (Protein shakes, protein bars). Your protein supplements do contain calories. As your meal volume increases, you have the option of concentrating on consuming high protein meals. As a result you can begin to take yourself off the protein supplements and the extra calories they contain.

A couple of new reports in JAMA Surgery shed some light on the impact of bariatric surgery on remission of Type 2 diabetes. One report focused on data from about 570 people who had undergone some type of bariatric surgery between 2005 and 2012, who also had Type 2 diabetes (T2DM). All had started with a BMI of 35 or more (morbid obesity — standard eligibility for such surgery). These folks were matched with diabetic patients who had not had surgery (1880 people), but were otherwise similar in terms of age when the operated people had surgery, sex and BMI. The main focus of the study was the extent to which T2DM remission occurred, and whether the level of hemoglobin A1c, or HbA1c, (a measure of long-term blood glucose control) decreased to less than 6.0 percent (any HbA1c over 6.5 percent is considered diabetes). The investigators, led by Dr. Jan Peter Yska from the Medical Centre Leeuwarden, Leeuwarden, the Netherlands reported that 95 (out of the 570) persons with T2DM who underwent surgery were in remission compared to only five patients in the non-surgical group (1880 total). The results also depended on the type of bariatric surgery involved. Gastric bypass surgery was the most effective, followed by sleeve gastrectomy and then by gastric banding (for more information on the types of bariatric surgery, read here). Thus, the researchers found, the positive effects of bariatric surgery could be seen for at least two years post operation. Although the standard cut point for bariatric surgery is usually a BMI of at least 35, some have queried whether or not such surgery would also benefit diabetes patients with lower BMIs. This question was investigated by Dr. Chih-Cheng Hsu from the China Medical University in Taiwan and colleagues. They examined records of 52 diabetic patients who received bariatric surgery — either sleeve gastrectomies or gastric bypass — and compared them to records of 299 T2DM patients whose conditions were managed medically. All patients had BMIs lower than 35. By five years post-surgery, the operated group had lost 21 percent of their initial body weight, bringing their BMIs down from about 31 to 24.5. In addition, their average HBA1c levels dropped from 9.1 percent to 6.3 percent over the same period. Thirty-six percent of this group had complete remission of their T2DM. In contrast, only one person in the medically-managed group, had a complete remission of their disease, and their HBA1c was, on average, 8 percent — still in the diabetic range. All differences between surgical and control groups were statistically significant. http://acsh.org/2015/12/bariatric-surgery-linked-to-diabetes-remission/ I suspect on the first study, the reason why the remission rate is so low is because they are lumping lap band patients in with RNY and sleeve patients.

According to your stats, you are showing the type of surgery that you had as Lap-Band but you are posting under the Gastric Bypass section. So I am guessing that you had a revision from lap-band to RNY gastric bypass surgery. If that is the case then the following applies. First, you should have received specific instructions that detail all the requirements. The types of foods and the volume of foods as a function of time since surgery are detailed in these instructions. After RNY surgery, the most important elements are meeting the 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. To meet your protein requirements, generally you need to rely on protein supplements (Protein shakes and later protein bars) to meet these goals. Your protein requirement is met by a combination of the protein you obtain from meals combined with the protein you obtain from supplements. Right after surgery you meal size is so minuscule (2 ounces per meal) that you must obtain your protein from protein shakes. But as time goes on and your meal volume increases, if you concentrate on consuming high protein meals, you can start to reduce the amount of protein you obtain from supplements. Fluids are a combination of the Water you drink during the day, other drinks such as crystal light, tea, decaf coffee, hot cocoa (using no-sugar added cocoa), milk, the water you consume when you take your Vitamins, the water you use when you make soup. So it is the fluid part of what you consume each day. Vitamins are extremely important if you had RNY surgery. This is because you body no longer converts food into vitamins. Without vitamin supplements, you will become vitamin deficient and many medical conditions will come into play. For the first 4 weeks following surgery - full liquids - 2 ounces (1/4 cup) per meal Weeks 5-8 - pureed foods - 2 ounces Weeks 9-15 - solid food - 3 ounces And these requirements evolve all the way up to a full cup at 18 months. Also, it really depends on the type of surgery that you underwent. The requirements of gastric sleeve are different than RNY gastric bypass. There is also surgery called mini gastric bypass that has completely different requirements. So follow the doctors directions. He should have provided you with specific detailed directions.

I used a Ninja with a single serving cup. It worked great but I wore it out in a year and had to buy another one. I bought a Nutri Bullet for my mother but it was more difficult to work with and clean. The main purpose of the blender is to blend the powder into the liquid. Otherwise it tends to clump together and as a result the Protein shake taste terrible. The second purpose is to allow you to blend in other food such as bananas into the Protein Shake. It also allows you to blend in ice or frozen fruit into the protein shake. A good blender is one of the best tools required after surgery.

I went from a size 3X down to a size Small in shirts and from a size 46 in pants down to a size 33. All in 7 months. So all I can say is BELIEVE.

Congratulations and simply wonderful.

Congratulations on your weight loss thus far. Pre-op and post-op weight loss both counts towards your goal and 121 pounds is significant. It is common to hit stalls during the "Weight Loss" phase and even gaining a few pounds during the process does occur. The three most important requirements after RNY gastric bypass surgery are meeting the daily Protein, Fluid, and Vitamin requirements. It looks like you are getting good exercise. Sometimes individuals after surgery go all-out on exercise, they convert some of their fat into muscle and muscle weighs more than fat. Thus they may experience a slight weight gain in the process. But your level of exercise does not appear too strenuous. So let us look at protein. Your daily protein requirement is satisfied by the protein you obtain from meals combined with the protein from supplements (Protein shakes and protein bars). In the beginning the amount of protein from your meals at a 1/4 cup per meal is so low that it is negligible. But as time goes on and your meal volume increases, the meal portion becomes important. The protein shakes that you are consuming contains calories and they can add up. So an important strategy as you progress to larger food volumes is to concentrate on meals that contain significant amount of protein so you can start to reduce the amount of protein shakes you take each day (and the calories these shakes contain). As my meal volume increased, I went for 3 shakes a day, down to 2, down to 1 and then down to none. When I hit my first stall, this was the strategy that I used and it worked for me.

Let's see, you are pre-op and have finished the first semester of college. O.K. I remember that, of course that was almost a half century ago but I still recall the experience. This is known as recharging your batteries for the next semester.

I am 31 months post-op RNY. I lost weight very quickly and then it leveled off after about 6 or 7 months and then I slipped into the Maintenance phase. Those that have gastric sleeve have a different experience. They tend to lose weight slower than RNY patients but the time until they reach Maintenance phase can be significantly longer. The weight loss you have experienced thus far seems very good. Unless you are really into strenuous exercise, which appears not to be the case, 120 grams of Protein per day seems a bit on the high side and might be the cause of your problem.

It is common to experience dumping syndrome after gastric bypass surgery. Generally this happens once or twice and they you learn the warning signs and just learn to avoid it. For me, I would eat some food and all was well, then the taste of the food became revulsive. Sometimes there would be outward signs like hiccups. My body was telling me time to quite. But if I failed to heed these warning signs and I took a few more bits, I was in full dumping syndrome mode. Since you are only a month post-op and not really into solid foods, I suspect what you experienced is not dumping syndrome. I don't think it was due to you drinking too much, too fast or with air bubbles in your Protein shake. Also avoid eating just prior to going to bed. I noticed that if my stomach hurt due to dumping syndrome, it was impossible to lay down and try and sleep. I had to get up into a sitting position (generally watch TV) for a couple hours until things settled down.

One of the problems that individuals that undergo RNY surgery sometimes experience is called "reactive hypoglycemia". Individuals experience low blood sugar within a few hours after eating. This link might help. http://www.mckinley.illinois.edu/Handouts/hypoglycemia_nutrition_reactive.html Also get back on your Vitamins. Your body, because of RNY gastric bypass surgery, no longer synthesizes vitamins from the foods that you eat. Therefore it is easy to become Vitamin deficient without taking supplements and thereby open the door to a slew of medical conditions that are caused by vitamin deficiencies. About a year after surgery I encountered a stomach flu. I didn't feel like eating and if I did, it generally led to diarrhea. I lost a pound a day for a week and then the flu was gone and life returned back to normal. I looked at the additional weight loss as a plus and tried to maintain this additional weight loss.

Good luck on your surgery and check back with us when you are on the other side. Let us know if we can be of any help.

Vertical nail ridges often become more numerous or prominent with age, possibly due to variations in cell turnover within the nail. If your fingernails change color or you develop horizontal nail ridges, consult your doctor. These changes could indicate an underlying health condition.

Congratulations.

I don't have any experience with synthroid. I am 31 months post-op from RNY surgery. I have spent the last 24 months in Maintenance mode. The following short articles describes my experience with weight loss in Maintenance mode. http://www.breadandbutterscience.com/Surgery2.pdf

I will pray for the success of your surgery. Check back with us when you are on the other side and keep us informed of your progress.

Several individual on this site have reported the condition. It is officially called "reactive hypoglycemia". Here is a link to the condition and the recommended approaches to deal with it. http://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/reactive-hypoglycemia/faq-20057778 For the majority of people, reactive hypoglycemia usually doesn't require medical treatment. It may help to pay attention to the timing and composition of your meals: * Eat several small meals and Snacks throughout the day, no more than three hours apart during the waking hours. * Eat a well-balanced diet, including lean and nonmeat sources of Protein, and high-Fiber foods, including whole grains, fruit and vegetables. * Avoid or limit sugary foods, especially on an empty stomach. * Be sure to eat food if you're consuming alcohol and avoid using sugary soft drinks as mixers.