James Marusek

Congratulations on your weight loss and welcome to the group.

Yes, the whole process can be overwhelming. To make things a little simple, there are three daily requirements to meet. These are Protein, Fluid and Vitamins. food is secondary because your body will be converting stored fat into the energy that drives your body. Thus you lose weight. For me and many others, after surgery I completely lost my hunger. It was not difficult to lose weight when hunger was not constantly, continually gnawing at my bones. The next thing to remember is that after surgery, your body will be in heal mode, so if you can't meet your protein and fluid daily requirements, don't panic. Healing comes first. You should be able to meet these daily requirements in the first week or two. That is your goal to meet these requirements as soon as possible. The next thing is don't panic if you don't lose weight from the get-go. During the surgery you will likely gain several pounds because they pump fluids into you during your stay at the hospital. So you will come home a few pounds heavier than when you started. It will take a few days to drop this additional weight. Follow the directions for meeting the daily protein, fluid and Vitamin requirements. Limit your portion size (by volume) as directed. And finally walk 30 minutes per day. The walking will make the whole recovery process go smoothly. If you aren't walking currently start today. It really helps. And then let the magic happen.

The strategy in the "Maintenance" phase is different than in the "Weight Loss" phase. Here is a link to a short article that may be of some help. http://www.breadandbutterscience.com/Surgery2.pdf

Congratulations.

Life is full of trade-offs. I had RNY gastric bypass surgery 31 months ago. Almost all my many medical conditions (high blood pressure, diabetes, severe acid reflux (GERD), sleep apnea) went into remission within a couple weeks after surgery and have remained there. So I traded my love of food for good health. It was a very good decision.

Uncomfortable to swallow. After surgery, I found that my tastebuds changed dramatically. I couldn't even drink the Water in the hospital because it tasted extremely chlorinated. When I got home, I still found it difficult to drink water. It wasn't painful. It just tasted bad. Eventually I found that I could tolerate Crystal Light, so that is what I used. Later I found that tea was good and also hot cocoa was good in the winter. But you can only drink the cocoa that has "no sugar added". Some people found that Soup would go down easier. Your total Fluid daily requirement can be met by the sum of the fluids you drink, the liquid in the Protein shakes and the liquids in the meals (such as soup). Even the water you swallow taking your Vitamins count towards you total.

It sounds like you might be entering the "Maintenance" phase. The approach during this phase is different than the "Weight Loss" phase. This short article may be of help. http://www.breadandbutterscience.com/Surgery2.pdf

Congratulations on your weight loss so far. It is common to experience stalls during your weight loss. So stay calm and let the magic continue to happen. I do not know if you ever completely get your taste back, but you will recover most of it over a year or two. I found combining foods such as in chili and Soups will provide you with good flavor. I am including links to a couple articles that describe my journey. They may be of some help. http://www.breadandbutterscience.com/Surgery.pdf http://www.breadandbutterscience.com/Surgery2.pdf

After RNY gastric bypass surgery, the three most important requirements are meeting the Protein, Fluid and Vitamin daily requirements. food is secondary. Since you seem to be having problems with at least two of these (fluids and protein). This inability needs to be dealt with. Four weeks is too long, contact your surgeon's office. As Djmohr stated, the cause may be due to a stricture.

Sorry I can't be of much help. I had diarrhea right after surgery because I was lactose intolerant and it wasn't until I stopped drinking milk that I got it under control. In your case, this has started much later post-op. Over the years, I have used bananas to control diarrhea.

Congratulations.

There is a condition called "reactive hypoglycemia" which is low blood sugar that occurs after a meal - usually within 4 hours after eating. Several individuals who underwent gastric bypass developed this condition even though they never had diabetes prior to surgery. Signs and symptoms of reactive hypoglycemia may include hunger, weakness, shakiness, sleepiness, sweating, lightheadedness, anxiety and confusion.

Are there any other symptoms? During the first few weeks after surgery, pulmonary embolism and a gastric leak from the anastomosis lead the list of life-threatening complications, according to James A. Madura II, MD, director of the bariatric surgery program at the Mayo Clinic in Scottsdale, Ariz. Any sustained heart rate reaching 120 beats per minute should be a red flag to check for a potential leak, Dr. Madura said. Christopher Still, DO, FACP, director of Geisinger's Obesity Institute in Danville, Pa., strongly agreed. “Tachycardia greater than 120 with or without left-side shoulder pain should be a leak until proven otherwise,” he said. Shortness of breath and tachycardia, according to both surgeons, also can be 2 potential red flags for another rare but life-threatening complication—pulmonary embolism. A pulmonary embolism is a blood clot that occurs in the lungs. Generally when you have surgery, they make you get up and walk every couple hours in the hospital to make sure you don't develop a blood clot. You are also given a prescription for a blood thinner that you self administer for around the first 10 days after the operation. Since you are 1 week post-op, this is the condition that I would be most focused on.

Yes. Your body fat is a good insulator. As you lose the fat you will find that you are much colder. When I go outside and shovel the snow, I am now using hand warmers. What a great invention.

I began eating bananas at about 1 month post-op. I blended them into my Protein shakes. It made the shakes tolerable to eat.

Two bits of advice. First, make sure that you walk 30 minutes each day. This will dramatically improve your recovery time. Second, if you haven't already cut out all caffeine and carbonated beverages, do it now. I had a 6 diet Coke a day habit. I went cold turkey when I entered the pre-op stage. I lost 20 pounds on that change alone. Also when I gave up caffeine I went through a week of severe withdrawal syndrome. Severe headaches and body aches. You don't want to compound this withdrawal with the effects of surgery. Get it over with now.

Best decision I ever made.

I have been using Citracal tablets. It was rough at the beginning because I could not swallow these because they were too large. It took 2 months before I healed to the point that I could swallow these tablets. In the meantime I had to crush them. They tasted like chalk. I found the best way to down these was to put the crushed tablets in a glass of Crystal Light. Once I could swallow them whole it was a major relief. I think expense is a major issue. You have to take so many of these, that you need to find the cheapest approach. After about a year and a half, I reduced the number that I was taking by a quarter. But when the blood work came in, they detected this and I was back on the full dose again. This is a requirement for the rest of my life. I have recently switched over to a generic brand of Citrical.

I think sometimes people just need a personal touch.

After surgery, you will need to take Protein supplements. Generally this takes the form of protein shakes or powders. After a few months you will be able to transition to some Protein Bars. But the statement that you made I will need protein supplements for the rest of my life is not accurate. In the beginning, you have to take protein supplements because the amount of protein you receive from you meals will be incredibly small because the volume of your meals will be incredibly small. As your meal volume increases post-op, if you concentrate on eating high protein meals, you can begin to eliminate your reliance on protein supplements. Your daily protein requirement is met by a combination of the protein you obtain from meals combined with the protein from supplements. Your taste buds may change after surgery. Therefore if you find a protein supplement now, it may not met your requirements post-op. After surgery it will be important that you find a Protein shake that you can tolerate. You don't have to like it, only be able to tolerate it. For me I used "Muscle Milk Light" and blended in a half a banana and Water using a Ninja blender with a single serving size. I could tolerate that. Over time I went from 3 protein shakes a day, down to 2, down to 1 and then finally ZERO. I haven't drunk a protein shake in a year and a half. If I need a little extra protein when I am away from home, I generally use a [Quest] Protein Bar.

I took no pain medicine after I left the recovery room. I didn't need to. I had very little pain. Besides pain medicine doesn't do much good, muscle relaxers are a better choice. I did't use any of those either. If you are concerned about pain, make sure that you walk about 30 minutes each day from this point forward. And once you get out of the recovery room walk every 2 hours while you are in the hospital. It will dramatically reduce any pain you might have. I began walking almost immediately after the recovery room. After a few hours, one of the nurses came in and was upset I was doing in her opinion too many laps. She said when the surgery anesthetics wear off I will be in extreme pain because of the excessive laps. So I cut them back a little. But when the anesthesia wore off I could hardly even tell. I kept watching the clock waiting for it, but it never came. I was in the hospital for 2 days and did a total of 100 lapse. They had a write board on the wall so that the patients could keep track. At the beginning it was a little tough because you had to haul around a portable stand that had the I.V. attached. But on the second day, they unhooked this and it was easier. Also make sure that you get a trapeze hanging bar above the bed so you can pull yourself up out of bed. It makes it easier. The nurse who administers pain medicine would come in the room and check my pain level. I always told her it was either a zero or 1 on a scale to 10 and I wanted no pain medicine. It was my impression she went away mad. My experience may not be typical. I suspect your surgeon will administer pain medicine while you are in the hospital. By the time you leave the hospital, I feel that you may not need any unless you experience some major complications.

After RNY surgery, I became lactose intolerant and as a result anytime I consumed milk or a milk product it would produce flatulence and severe diarrhea. Therefore I had to stay away from anything that contained lactose, even some Protein powders. This condition healed after about 2 months.

Good luck on your surgery. I will pray for you. Check back with us when you are on the other side and let us know how it went.

I don't know if I have any good answers for you except one year will fly by pretty quick. I did notice that when you combine foods together, it adds a lot of flavor. So I primarily relied on chili and Soups. I think the kidney Beans in the chili seemed to satisfy my urging to eat bread.

At 4 weeks out your body is still in heal mode. Transitioning to solid food too soon can damage your stomach. For those with RNY surgery, solids are not recommended until week 9.