James Marusek

Congratulations.

I had RNY gastric bypass rather than VSG, so some of my answers may be different from a VSG patient. 1. What day did you have your port removed and do a leak test? I didn't have a port. If a leak test was done, it was done during surgery. 2. Did the leak test make you have diarrhea? (Just thinking if I should spend an extra day there because the idea of being sick like that on a plane sounds like 0 fun) Diarrhea was not a problem, gas was. 3. Did you need to take blood thinners for flying so soon after surgery? I took blood thinners to prevent blood clots. The blood thinner was Lovenox and I took it for little over a week. It is very important to take this. You will also need to wear a TED hose until your activity is back to normal. 4. Is it true that after surgery you tend to have a lot more gas? Even months after surgery.... Yes. This is especially true in the hospital. Walking helps to relieve this initial gas pains. 5. I have PCOS which is a contributing factor as to why I'm considering this surgery. I'm not wanting kids just to be a healthy weight.....for once. Anyone else out there have PCOS and the surgery? How is your journey going? I don't have PCOS 6. Is it realistic to be able to go to work a week post op? At one week post-op, I was back on my feet again. But you may want to consider working part time for the second week, so that you can ease into it. 7. I have zero desire to tell anyone I'm having this surgery, is going there solo etc okay? Were you able to drive yourself home after you made it back? I had someone drive me home from the hospital. You will not be cleared to drive until the effects of any narcotic pain medicines that you consumed after surgery has passed through your system. I didn't take any pain medicine, in part so that I would be able to drive sooner. But even at that I didn't start to drive myself until around a week post-op. 8. I've heard there can be a lot of pain even months after surgery, eating different foods etc is this the rule or the exception? Prior to surgery I was constantly hungry. When I was eating a meal, I was already figuring out what I would have for my next meal. After surgery I lost my hunger and my meal portions were so small that it wasn't an issue. Because of RNY if I consumed more than what my stomach (reduced size) could hold, it would lead to dumping syndrome. The effects of dumping syndrome can last for around 4 hours and is painful. But there are pre-triggers that can warn you if you are approaching that limit. 9. If you've had the surgery knowing what you know now what is one piece of advice you wish you could have given your self pre-surgery? 1. Take a good before photograph of yourself, so that you have something to compare to after surgery. Many times we are blind to our obesity. We do not see ourselves. Therefore when the weight begins to drop off rather dramatically, we question if this is really happening. Photographs are a good visualization of our success. Many people carry a before and after photo with them, just to remind themselves of their success. 2. Walk 30 minutes each day, every day until surgery (or equivalent exercise). Walking helps the recovery process go smoothly and minimized the pain levels from surgery. 3. Wean yourself from caffeine and carbonated beverages now. After I gave up my 6 diet coke a day habit, I suffered from a week of severe withdrawal syndrome consisting of severe headaches and body aches. I was miserable. You don't want to combine the effects of caffeine withdrawal with the effects of surgery. 10. How uncomfortable was flying? If driving was an option would that have been easier? When flying would you have waiting more time been a better idea or was it okay to go when you were cleared? After surgery, you will be under a reduced weight limit for what you can pick up. Your suitcases will be above that limit. So you will need to have someone help you with getting your suitcases home.

My surgery discharge directions read "Eat 3 meals daily, eat slowly and chew food well; avoid skipping meals." The first meal of the day is Breakfast and generally it is the meal that many individuals skip. A research study in Spain examined the possible link between breakfast consumption and obesity — especially abdominal obesity, which is the type most closely associated with the risk of type 2 diabetes and other metabolic problems. This epidemiological study included 1655 adults, about half each of men and women. About 53 percent were between 18 and 49 years of age, and the rest were between 41 and 64 years old. Two-thirds reported that they were habitually inactive ('active' meant that they performed at least 30 minutes per day of physical activity as part of their daily life, or at least 2 hours per week of structured physical exercise), and about one-third overall said they were current smokers. Participants' height, weight, and circumferences were measured during personal interviews, and food consumption was assessed by 3-day dietary records. Only a small percentage of participants reported never eating breakfast — 3.6 percent overall, while 82 percent said they always ate breakfast and about 14 percent said they sometimes ate that meal. Dairy foods with cereals were the most frequently reported items consumed for breakfast. Men with Wt: Ht ratios > 0.05 (i.e., abdominal obesity) were more likely to be breakfast skippers than their slimmer counterparts, and there was an inverse significant statistical association between always eating breakfast and the odds of abdominal obesity. Participants who ate breakfast 'sometimes' and 'always' were less likely to report that they smoked (43 and 33 percent respectively) compared to those who never ate breakfast (51 percent): this difference was statistically significant. Furthermore, those who skipped breakfast were also more likely to have other unhealthy characteristics such as physical inactivity. Thus, the authors concluded: [T]here appears to be a greater likelihood of health-compromising behaviours in people who miss breakfast, including increased prevalence of smoking, poorer food choices and greater energy intake from snacks. https://www.acsh.org/news/2017/12/02/breakfast-might-be-marker-healthy-lifestyle-could-it-prevent-obesity-12226 So generally it seems research points to the importance of breakfast (primarily because it kick-starts your day, and minimizes the temptation to snack).

After surgery, my taste buds changed dramatically. Many undergo this change. For others it seems to affect their sense of smell.

Congratulations.

I am not too sure what you mean by the pouch getting clogged up. If I consume too much food, I will get dumping syndrome. It is a horrible experience which lasts for several hours (around 3-4 hours). Generally it is relieved by vomiting up the food. If you try to lay down during an episode, it will be almost impossible to sleep. Generally I just try and stay awake and watch television until it eases up. For that reason it is best not to eat prior to bedtime. There are pre-triggers that will tell you if you are approach dumping. This can be sneezing, congestion, food changing taste radically, mucous forming. The differ between people. But if you detect these pre-triggers it is good to stop eating immediately because the next bite can put you over the edge.

There are two phases to weight loss surgery. These are the weight loss phase and the maintenance phase. I had RNY gastric bypass surgery and I slid into the maintenance phase at around 7 months. My weight dropped like a lead brick. Those who have sleeve surgery tend to lose weight at a slower pace and encounter many stalls along the way. They can achieve almost the same level of weight loss because the transition to the maintenance phase may take a couple years. The three most important elements after RNY gastric bypass surgery are 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. Weight loss is achieved after surgery through meal volume control. You begin at 2 ounces (1/4 cup) per meal and gradually over the next year and a half increase the volume to 1 cup per meal. With this minuscule amount of food, it is next to impossible to meet your protein daily requirements by food alone, so therefore you need to rely on supplements such as protein shakes. Without sufficient protein, your body will scavenge protein from other areas of your body, such as your muscles. Protein is extremely important after surgery as its job in the body is to build and maintain tissues including your body's major organs and skeletal muscles. Protein deficiency, when continued over a long period of time can cause a disease known as protein caloric malnutrition. Common symptoms are poor healing, fatigue, hair loss and muscle wasting. Immediate post op, protein promotes healing of the staple line and incisions. I am not an expert on sleeve surgery, so I am not a good source on their diet approach. In the weight loss phase, I was restricted from consuming fats and sugars because the part of my stomach that normally process this type of food was cut away. But when I reached maintenance, my intestines evolved to be able to accept this type of food again. After I reached maintenance I had a discussion with my nutritionist about meal composition. Her advise was meals should consist of equal parts of protein, fats and carbs but always put protein first. Snacks should be limited to primarily whole food options: nuts, natural nut butters, fruits, veggies, boiled eggs, string cheese, yogurt with berries and almonds, tuna pouches. Avoid processed packaged foods as much as possible. I knew that fats are important because they help to control hunger. Also because I was diabetic prior to surgery, I restrict myself from sugars. So primarily, I followed my nutritionist guidelines but also incorporate the use of fats into my diet. I am 4 1/2 years post-op.

Good luck on your surgery and check back with us when you are on the other side and let us know how it went.

It is a tough decision. My primary reason why I had RNY gastric bypass surgery was because my obesity finally reached a point that it drove my health into the tank. I had high blood pressure and diabetes and prescription meds were losing their effectiveness. Also I slid into a number of other health issues like GERD, sleep apnea to name a few. Generally I had reached my date code and my life was on a downward spiral. Within a couple weeks after surgery almost all my health conditions went into remission and remained there. I am 4 1/2 years post op. It even corrected another health issue, asthma. But this was a much slower process, taking a couple years. Now I am off all my prescription meds. All of them. So I am very pleased with the results and would do it again in a heartbeat. Most individuals who try dieting to lose weight suffer the yo-yo effect. They lose weight, it is good for awhile but then they go off their diet and the weight comes back on and then some. Every diet equals another 10 or 20 pound increase. I am not familiar with your conditions (Hashimoto's thyroiditis and polycystic ovary syndrome (PCOS)). But I have heard these conditions discussed on this website before. So you might search the internet for a discussion or perhaps someone with these conditions can chirp in.

Generally while in the hospital, individuals gain weight because they pump quite a bit of fluids into your body. This weight is generally lost within the first week home. The first few weeks after surgery, your body is in a major heal mode. Do not be too concerned about weight loss during that time.

After my surgery, I lost my ability to swallow medium to large pills. But this condition is not permanent. About 2 months post-op, this problem dissolved away. During the two months, I had to either split or crush my vitamins. The worse was Calcium. They were large horse pills and when crushed they tasted like chalk. The way I was able to get these down was to mix the powder in with a glass of crystal light. I would mix it and chug it down. There was always paste left over at the bottom of the glass, so I added some more Crystal Light and chug it down again and again. After about 4 or 5 times, I had consumed the calcium paste.

Good luck on your surgery. If you haven't already done these, I would recommend the following: 1. Take a good before photograph of yourself, so that you have something to compare to after surgery. Many times we are blind to our obesity. We do not see ourselves. Therefore when the weight begins to drop off rather dramatically, we question if this is really happening. Photographs are a good visualization of our success. Many people carry a before and after photo with them, just to remind themselves of their success. 2. Walk 30 minutes each day, every day until surgery (or equivalent exercise). Walking helps the recovery process go smoothly and minimized the pain levels from surgery. 3. Wean yourself from caffeine and carbonated beverages now. After I gave up my 6 diet coke a day habit, I suffered from a week of severe withdrawal syndrome consisting of severe headaches and body aches. I was miserable. You don't want to combine the effects of caffeine withdrawal with the effects of surgery.

Good luck on your upcoming surgery. Remember to take a before photograph.

Congratulations.

Dehydration can cause drowsiness and it can also cause your blood pressure to drop. Here is a link to a 2012 thread that discussed the issue. https://www.bariatricpal.com/topic/211099-anyone-else-dealing-with-low-blood-pressure-post-surgery/ The issue might be an electrolyte imbalance. According to the internet: Electrolytes are minerals in body fluids that contain an electrical charge. Sodium, calcium, phosphate, carbonate, potassium, chloride and magnesium are the main electrolytes. Maintaining an appropriate electrolyte balance can improve muscle action, blood chemistry and other processes, according to MedlinePlus. However, when the amount of water in the body changes, the levels of these electrolytes may become too high or too low. The specific symptoms of an electrolyte imbalance vary greatly depending upon which electrolyte is unbalanced, but may include thirst, weakness, drowsiness, sluggishness, fatigue, confusion, cramps, abnormal heart rhythm, loss of appetite, nausea, vomiting or seizures.

Many individuals on this site report having difficulty in meeting their protein and fluid daily goals right after surgery. That is because their stomach is in a major heal mode. Generally if they continue to work towards their goals, they will see progress on meeting them after the first few weeks.

Congratulations and good luck on your surgery. If you haven't already done these, I would recommend the following: 1. Take a good before photograph of yourself, so that you have something to compare to after surgery. Many times we are blind to our obesity. We do not see ourselves. Therefore when the weight begins to drop off rather dramatically, we question if this is really happening. Photographs are a good visualization of our success. Many people carry a before and after photo with them, just to remind themselves of their success. 2. Walk 30 minutes each day, every day until surgery (or equivalent exercise). Walking helps the recovery process go smoothly and minimized the pain levels from surgery. 3. Wean yourself from caffeine and carbonated beverages now. After I gave up my 6 diet coke a day habit, I suffered from a week of severe withdrawal syndrome consisting of severe headaches and body aches. I was miserable. You don't want to combine the effects of caffeine withdrawal with the effects of surgery.

I found that softer foods such as chili and soups went down much easier than harder foods such as steak and chicken. So that is what I have primarily relied on. I have included some recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf

Congratulations.

Good luck on your surgery and when you are on the other side, let us know how it went.

Good luck on your surgery. Here are a few suggestions. 1. Take a good before photograph of yourself, so that you have something to compare to after surgery. Many times we are blind to our obesity. We do not see ourselves. Therefore when the weight begins to drop off rather dramatically, we question if this is really happening. Photographs are a good visualization of our success. Many people carry a before and after photo with them, just to remind themselves of their success. 2. Walk 30 minutes each day, every day until surgery (or equivalent exercise). Walking helps the recovery process go smoothly and minimized the pain levels from surgery. 3. Wean yourself from caffeine and carbonated beverages now. After I gave up my 6 diet coke a day habit, I suffered from a week of severe withdrawal syndrome consisting of severe headaches and body aches. I was miserable. You don't want to combine the effects of caffeine withdrawal with the effects of surgery.

I had surgery at a Center of Excellence for Bariatric Surgery. These Centers of Excellence are available in many states. The Centers of Excellence provide a complete support for the surgery. There are many components that require a range of specialist beyond just a surgeon who specializes in Bariatric Surgery. They include nutritionist, psychologists, a hospital that specializes in bariatric surgery, staff that work insurance issues, pre-op testing, weight loss and exercise programs, bariatric surgery support group meetings, five years of post-op follow-ups. It is like a "full meal deal", no pun intended.

I used Muscle Milk Light (Vanilla Creme) protein powder blended with water and a half a banana.

It is not normal for your weight loss to come to a prolonged dead stop after the 3rd week. So you will need to investigate the cause. What type of surgery did you have? I had RNY gastric bypass and did not encounter a stall that lasted more than a couple days during the beginning. Sleeve patients tend to encounter more stalls and their stalls last longer. So you might consult your surgeon's office about this. The three most important elements after RNY gastric bypass surgery are 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. Weight loss is achieved after surgery through meal volume control. You begin at 2 ounces (1/4 cup) per meal and gradually over the next year and a half increase the volume to 1 cup per meal. With this minuscule amount of food, it is next to impossible to meet your protein daily requirements by food alone, so therefore you need to rely on supplements such as protein shakes.

After returning from the hospital, many people find it difficult to sleep. Some people will sleep on a recliner for a few days. But don't do what I did - which was try to sleep on a water bed. Every time I tried to get up, it was instant pain. As you get further along and the fat disappears between you knees, it can be very difficult to sleep on your side because you can feel your bones rubbing together. I found that sticking a pillow between my legs at night help this immensely.