James Marusek

Good luck on your surgery and let us know if we can be of any help.

Congratulations on you weight loss. I have never heard of CLA.

I found Quest bars to be very good. They have a variety of flavors, so try a sampling to pick the one you like the most. After I picked the kind I liked the most, I ordered them by the box on Amazon over the internet to get the best prices.

At your stage, the most important elements to the program is meeting the minimum daily requirements for Protein, fluids and Vitamins. food is secondary. This is because your body is converting stored fats into the energy that drives your body. Thus you lose weight. Don't worry, you will not starve to death. Weight loss is achieved by portion control. In the beginning you are limited not only to what foods you can eat at each stage but also most importantly the volume of food you can consume at each meal. So if you really want to lose the weight stay with the program. After you lose the weight you will transition from a "Weight Loss" phase into a "Maintenance" phase. For me this took around 6 or 7 months. This happens quite naturally. You just stop losing weight. This time interval may vary by the amount of weight you need to lose. This also varies by the type of surgery. RNY is quick whereas Sleeve is slower. In the maintenance phase the goal is to maintain the weight that you lost. This is done by hunger control. Here are a couple articles that I wrote about my experiences: http://www.breadandbutterscience.com/Surgery.pdf http://www.breadandbutterscience.com/Surgery2.pdf

Welcome and let us know if we can be of any help.

There are 2 phases to gastric bypass surgery. These are the "Weight Loss" phase and the "Maintenance" phase. In the "Weight Loss" phase, weight reduction is achieved through portion control. Your weight loss will eventually level off and you naturally slide into the "Maintenance" phase. In this phase the weight loss you achieved is maintained through hunger control. I am 28 months post-op from RNY surgery. My current weight is very near my bottom weight. I use fats to effectively manage my hunger. So in general I am not hungry. After surgery the part of the stomach that processes fats and sugar is cut away. That is why if you consume fats or sugars, you may experience the pain of dumping syndrome. But after about a year, you body changes and your intestines learn to process fats and sugars. At this point you can use fats to manage hunger. I put together a short article that explains the process. http://www.breadandbutterscience.com/Surgery2.pdf

Right after surgery, the most important requirements are Protein, Vitamins and fluids. It is probably not possible to take your blender with you to work to mix up your Protein shakes, so explore using premixed Protein drinks. Vitamins will have to be spaced throughout the day and you will probably find it very difficult to swallow for a few months. I used pill splitters and pill crushers. But you might want to explore some of the other types of vitamins other than in pill form. Many people lug around large bottles of fluids (Water, Crystal Light, sugar free gator-aid etc.) all day to achieve their Fluid requirements. Meals are secondary because your body will be converting your stored fat into the energy that drives your body - thus you lose weight. Anyways the volume of your meals are ridiculously small in the beginning. I was driving a few days after surgery but your doctor will not permit you to drive if you are still taking narcotic pain medicine. After I left the recovery room I refused all pain medicine for that reason. I didn't really feel much pain. Of course I was walking all the time before and right after surgery which really helps loosen things up making the process almost painless. Also I have a very high pain threshold. You will be giving yourself blood thinner medicine by injection after you leave the hospital. This is to prevent blood clots from forming. I hated this. But it was for only a week or two. You will probably do this at home. You will bruise very very easily. You should not sit in a sitting position for more than 1 hour at a time. It means that you should get up and walk around every now and then during the day. This is to prevent blood clots from forming during the first 6 weeks after surgery. You need to do the incentive spirometer 6 times per day for the first 2 weeks after surgery. You will need to wear TED hose until your activity returns back to normal. Also you will probably wear your binder for at least 2 weeks after surgery.

After surgery, my face began to wrinkle. These were very fine wrinkles. I literally looked like I was 100 years old. My wife suggested I use a product called BioOil which is available at CVS and Walmart. It took care of the problem. As Djmohr said the problem might be that you are not meeting your daily Fluid requirements.

After surgery, the guidelines state avoid caffeinated and carbonated beverages because they: * Stimulate appetite * Can be irritating to stomach lining * Acts as a diuretic * Increases gas * Pressure against staple line * May lead to ulcer formation I avoided caffeinated beverages for about the first year after surgery, then I began using caffeinated teas and coffee. While you are in the "Weight loss" phase, it is probably a good idea to suck it up and avoid caffeine. When you "Weight loss" levels off and you enter the maintenance" phase, I think you have a little more discretion.

Health-wise I have experienced only a vast improvement in my overall health since my RNY surgery 28 months ago.

For those who have butt pain, a gel cushion will help. Pick them up at Bed Bath and Beyond. In winter when it gets really cold and I venture off to shovel snow, I now us hand warmers in my gloves. What a great invention. I would always drive with the window open even when it got down in the 40's. This always drove everyone else in the car crazy. I now feel the cold. My wife says it is nature's revenge. "What comes around, goes around!"

No just continue with the program and let the magic happen. Stalls are common.

Gareth J. Hollands from the University of Cambridge, U.K., and colleagues, examined data from 72 studies (meta-analysis) that compared at least two groups with respect to their choices of food, alcohol, or tobacco packaging, portion size and tableware (dishes and glasses) size on food consumption. They concluded "successfully reduce the size, availability and appeal of larger-sized portions, packages, individual units and tableware can contribute to meaningful reductions in the quantities of food (including non-alcoholic beverages) people select and consume in the immediate and short term.” http://acsh.org/2015/09/change-your-setting-to-help-you-eat-less/ In other words, one might conclude that in part obesity in the U.S. is related to the large overly generous portion size of meals served in many of our restaurants. Many undergoing WLS change their tableware (the size of their plates, bowls, glasses and spoons) after surgery. This change reduces portion size or the temptation to overeat. Even after 28 months post-op I use a miniature metal spoon to eat which slows the rate that I eat (I tend to gobble food down).

I don't understand your question. It seems like you are saying that your gynecologist (or gastroenterologist) believe that you will need supplements of Iron via intravenous needles after about 10 years. I am 28 months post-op and this is the first time I have heard about this. RNY gastric bypass surgery cuts out the part of the stomach that converts foods into Vitamins and as a result, anyone who undergoes this surgery must take Vitamin supplements for the rest of their life. These are normally in the form of vitamin pills.

I began using Protein bars around the third month post-op. After RNY gastric bypass surgery, the part of your stomach that processes fats and sugars has been cut away, so consuming them at this point may produce dumping. Plus consuming protein bars that contain sugar is counter productive when it comes to weight loss. There are many varieties of protein bars that do not contain sugar and provide high levels of protein. They are great when you are on the go and cannot drag your blender around to mix up a Protein shake.

Sounds like you are experiencing dumping syndrome caused by trying to consume too much at a meal. Are you constraining yourself to the prescribed meal volumes? Another possibility is that you developed a stricture. But I would think at 3 months, this is rather late. In some cases, scar tissue or inflammation can narrow the new connection between the stomach and intestine. This is called a stricture. Strictures usually develop four to six weeks after surgery, and rarely occur. Patients with strictures will notice that they are progressively less able to take in fluids and food. Strictures can be treated with an endoscope, which is a thin, flexible tube with image sensors and special tools at the tip. A doctor will use an endoscope with a tiny inflatable balloon at its tip to open the stricture. Anyways it is important to focus on the most important elements which are Protein, fluids and Vitamins. Food is secondary because your body is converting your stored fat into energy and thus you lose weight. So from what you said, work on your protein problems. At your stage another option other than Protein shakes becomes available. These are Protein Bars such as Quest Bar.

With Iron, it is important to separate that from any Calcium intake, because the absorption of iron will be inhibited. You need about a 2 hour separation in time. Since you are pre-op, you may be deriving calcium from milk products or other natural sources or from Vitamins that contain calcium. I was low on iron after surgery, so I moved my iron supplement to the end of the day and took it just before bedtime to get the most benefit. In your case you might take one before bedtime and the other sometime during the day when there is no conflict with calcium.

I am 28 months post-op RNY surgery. I experience severe heartburn before surgery but none afterwards. I was prescribed Omeprazole (Prilosec) for the first year after surgery to help my stomach to heal. Prilosec was what I normally used when I had heartburn before surgery. So It wasn't until one year after surgery that I knew that my severe heartburn (GERD) was in remission. Sometimes dumping syndrome mirrors some of the same symptoms as severe acid reflux. So maybe you are experiencing an adverse reaction to fats (in milk products) or sugars due to the RNY surgery (part of your stomach that normally process these has been cut away).

Sounds O.K. to me. I lost 20 pounds pre-op and noticed that my blood pressure was getting low so I cut the dosage in half. After RNY surgery I noticed that my blood pressure was getting low at about 2 weeks and so I discontinued my blood pressure meds. I told my doctors when I saw him months later and he concurred. Like you I monitored my blood pressure for awhile. I am now 28 months post-op and my high blood pressure continues to be in remission.

I had the shots for a year. My wife administered them once per month. But the problem is she is afraid of blood. So she would look away as she stuck the needle into me. I finally decided this was not good and switched over to a daily B12 sublingual tablet.

Weight loss from RNY gastric bypass surgery is due to portion control. So if you are doing everything the doctor ordered (meal volume restrictions, Protein, Fluid, and Vitamin requirements, along with exercise) then the weight loss should happen. Give it a little more time for the magic to happen. As your meal volume increases the more you are post-op, you will have the opportunity to shift off your protein supplements (protein shakes) if you concentrate on consuming high protein meals. Your protein requirement is the amount of protein from protein supplements combined with the amount of protein from meals. (So refigure you total protein intake whenever the regiment alters the meal volume.) This will reduce the calories that you are consuming with the Protein shakes and that can allow your weight loss to continue without stalling out.

Signs and symptom hypothyroidism may include: Fatigue Increased sensitivity to cold Constipation Dry skin Unexplained weight gain Puffy face Hoarseness Muscle weakness Elevated blood cholesterol level Muscle aches, tenderness and stiffness Pain, stiffness or swelling in your joints Heavier than normal or irregular menstrual periods Thinning hair Slowed heart rate Depression Impaired memory It could account for some of your recent weight gain. It appears to be testable and treatable. http://www.mayoclinic.org/diseases-conditions/hypothyroidism/basics/definition/con-20021179

Weight loss is achieved through portion control. At three months out, you should be eating three ounces of food per meal. That is less than 1/2 cup. If you want to lose weight you must limit yourself to this amount of food. Even though you don't dump and can tolerate all types of food, that doesn't mean that you should eat 1 1/2 cups of food per meal. If you are eating Soups the Water portion of the Soup does not count. Measure out your foods if you want to lose more weight.

Your taste buds may change after surgery. So you may want to wait until after surgery before you experiment with various brands. There are quite a few available. It is important to find one that you can tolerate after surgery.

I have put some of the recipes that I used in the following article. http://www.breadandbutterscience.com/Surgery.pdf I concentrated on using high protein chili and soups.