James Marusek

They are at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf

Oranges showed up on my acceptable food groups at month 4. So a small glass of natural, no sugar added orange juice might be O.K. then. Orange juice has a lot of natural sugar, so I would recommend holding off until then.

I experienced this. I had my surgery over 4 years ago, so I don't really remember how long it lasted. Maybe a week or two.

Belts will hold up most pants. I found that I could shorten cowboy type leather belts by cutting the ends shorter and repunching the holes. It is O.K. to buy a pair of new clothes as you lose weight, but try and buy them so tight that you feel like you might pop a button. Weight drops quickly and before you know it, it will be a perfect fit. It is a great feeling when it does.

I am sorry you experienced all these problems. It seems like you had much more than your fair share of problems.

Congratulations.

There are two phases to gastric bypass surgery, the weight loss phase and the maintenance phase. I am over 4 years post op RNY gastric bypass surgery. This describes my approach to the maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

It is common to do a little experimentation after surgery. That is how we learn. Some people can tolerate anything after surgery while others have problems and can tolerate very little. Weight loss is achieved during the short weight loss phase through meal volume control. The two operative words here are short and volume. So if you want to maximize your weight loss during this phase, you need to adhere to the program guidelines. I slid into the maintenance phase at 7 months.

Congratulations on losing 112 pounds (8 stones).

A new study, partly funded by the National Institutes of Health and published in the European Journal of Nutrition, reported that decaffeinated black tea "alters energy metabolism in the liver by changing gut metabolites." For mice ingesting it, intestinal changes were identified where "bacteria associated with lean body mass increased." In the experiment four groups of mice placed on different diets: low-fat, high-sugar (LF/HS); high-fat, high-sugar (HF/HS); high-fat, high-sugar and green tea polyphenols (HF/HS-GTP); and high-fat, high-sugar and black tea polyphenols (HF/HS-BTP). Researchers concluded that "the weights of the mice that were given green or black tea extracts dropped to the same levels as those of the mice that received the low-fat diet throughout the study." “Our new findings suggest that black tea, through a specific mechanism through the gut microbiome, may also contribute to good health and weight loss in humans,” said lead author Susanne Henning, an adjunct professor at the UCLA Center for Human Nutrition. “The results suggest that both green and black teas are prebiotics, substances that induce the growth of good microorganisms that contribute to a person’s well-being.” The researcher from UCLA wrote about the bone density benefits of black tea when the American Journal of Clinical Nutrition published a study in late 2015, which prompted us to write that the news suggested "drinking three cups of tea per day may cut down on the risk of fragile bones among the elderly, as well as reduce the risk of illnesses such as cancer and heart disease." https://www.acsh.org/news/2017/10/04/weight-loss-aided-black-tea-study-suggests-11916

Since your mom is overweight with high blood pressure and diabetes, there is a good chance that you may be headed down the same road. My mom had diabetes and believe me this is a very debilitating condition. I developed high blood pressure and diabetes as the years went on and decided to not travel down the same path. I had RNY gastric bypass surgery over 4 years ago and have not regretted this decision. All my medical conditions went into remission and stayed there. One of the reasons why I decided to have the surgery was to be there for my grandkids. So look at this as something you are doing for your children. So you can be healthy and be there as they grow up, get married and have children of their own.

At your stage, I would recommend three things. 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.

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

I am not sure what type of surgery you had. Assuming you had gastric bypass, one thing to do now at this stage is to assess your protein intake. Your daily protein requirement is met by a combination of the amount of protein you obtain from food combined with the amount of protein from protein supplements (protein shakes, protein bars). Right after gastric bypass surgery, the volume of food you consume is minuscule (2 ounces) per meal. But as you get further along, the meal volume increases. Therefore you have a very important option available to you. As a result, you can begin to reduce your reliance on protein shakes. I went from 3 a day, down to 2, down to 1 and eventually none when I reached 1 cup per meal at a year and a half post-op. This is important because protein shakes contain calories. If you can reduce your caloric intake, then you can end a stall. At least that was the approach that I used and it worked for me.

Another benefit of Bariatric Surgery. A new Centers for Disease Control and Prevention (CDC) report shows that 40 percent of all U.S. cancer diagnoses can now be linked to overweight and obesity. Out of all cancer diagnoses, nearly 55 percent of female cases and 24 percent of male cases were linked to overweight and obesity. These cases statistically affect older adults, mostly between the ages of 50 and 74-years-old. http://www.foxnews.com/health/2017/10/04/cdc-40-percent-cancers-linked-to-obesity-overweight.html

It depends upon the surgery. For RNY gastric bypass patients and Duodenal Switch patients taking vitamin supplements is an absolute must.

Here are a couple links for this condition. https://www.webmd.com/digestive-disorders/anal-fissure-treatment#1 http://www.mayoclinic.org/diseases-conditions/anal-fissure/diagnosis-treatment/drc-20351430

Don't beat yourself up. Right after surgery, your body is in a major heal mode. Healing is the most important objective at 18 days post-op. During your hospital stay your body was pumped full of fluids. So generally when you leave the hospital you actually weighed more than when you entered by several pounds. So the first few days after surgery, you must lose that additional weight first. After surgery I lost my hunger and it was not difficult to lose the weight when hunger was not constantly continually gnawing at my bones. But the loss of hunger does not really kick in until you transition to solid foods. For my surgeon directions, the first 4 weeks I was restricted to full liquids, then the next 4 to pureed foods and it wasn't until week 9 that I was permitted solid foods. So in the beginning you may experience false hunger pains. When you chew food, your body releases certain chemicals that help with the digestive process. So for many, the hunger pains are tied to the inability to satisfy their need to chew foods. So the best advise I can give you is follow your surgeon's guidelines for your daily protein, vitamin and fluid requirements and follow your surgeon's guidelines for meal volume size and composition. And don't get stressed out. It is way too early.

I found that softer foods such as chili and soups went down much easier than harder foods such as chicken and steaks. So therefore I relied on these. I also found that mixing food groups together gave it more flavor and it brought back some of the enjoyment in eating meals. Chili and soups also allowed me to use spices in my meals. I put some recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf I did not like protein shakes at all. So as my meal volume increased, I was able to derive more protein from my meals and begin to offload my reliance on protein shakes. When my meal volume increased at the end of a year and a half to 1 cup per meal, I was able to offload all my protein supplements. But this approach only works if one concentrates on consuming high protein meals.

Most of the pain that I experienced was immediately after the surgery and walking reduced this pain significantly.

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 strictly avoid processed sugars. I have a sweet tooth and that is one of the major causes that contributed to my weight gain over my lifetime. I limit myself to artificial sweeteners (such as Splenda and sugar alcohols), to natural low calorie sweeteners (such as Stevia) and to the natural sugars found in fruits and milk. I had diabetes. That went into remission when I left the hospital two days after surgery and I have not taken any diabetic medicine ever since and my blood sugar levels are good. I test my blood sugar levels periodically. I read the labels of all food that I consume. I look at the grams of sugar per serving. If it is above 5 grams, I look at the ingredients. The ingredients are listed in order by highest percentage, and if the first 5 ingredients contain processed sugar (in any of its many forms), then I avoid this food, like a plague.

Congratulations on your 88 pound weight loss so far. I think I am missing something. Was there a before and after photo?

Right after surgery, I lost my ability to swallow large pills such as the large calcium pills and I had to crush them. It was like eating chalk. The only way I could down these was by mixing them with crystal light and drinking them down. Because they formed a paste at the bottom of the glass. I had to remix these and chug them down several times. Luckily my inability to swallow lasted only a couple months and then I was back to normal.

A duodenoscope is threaded through the patient's mouth and used to visualize the stomach and duodenum (the upper gastrointestinal (GI) tract). It can also be used to drain fluids from pancreatic and biliary ducts that would otherwise require more invasive surgery. The major problem with this equipment is the difficulty in cleaning it to prevent the transmittal of superbugs (bacteria immune to current antibiotics). This week, the U.S. Food and Drug Administration (FDA), took a step in the right direction by approving a new tool to add in the fight against superbugs - the ED34‑i10T Video Duodenoscope made by Pentax Medical. This instrument has a removable end cap that allows the channels (fiberoptic cables) to be cleaned more efficiently. https://www.acsh.org/news/2017/09/25/new-device-stops-superbug-infections-their-tracks-11867