James Marusek

Generally, the sleeve will only make severe acid reflux (GERD) worse. That is why you doctor is recommending gastric bypass. Some individuals have the sleeve but after awhile have to have a second surgery to gastric bypass because of severe acid reflux. I had severe acid reflux prior to surgery. My doctor recommended gastric bypass. I am 4 years post-op and have not been bothered by severe acid reflux since my operation.

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 surgery, I found that my taste buds changed. Many foods that I use to enjoy became flavorless. I found that softer foods such as chili and soups went down much easier than harder foods such as meat. It also added a lot of flavor to my meals and eating became somewhat enjoyable. I have included some recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf

Since surgery is only a few days away, 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.

Good luck on your surgery and remember to Walk, Walk, Walk.

Since you objective is to not lose any more weight, your goals in having RNY gastric bypass is quite different than most of us. In my case I began 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. My surgeon provided very specific directions (a half day class). After surgery your stomach is in a major heal mode. That will take several weeks. So pace yourself. The transition to solids can be difficult, especially meats. The three most important elements after RNY gastric bypass surgery are to meet your daily protein, fluid and vitamin requirements. Food is less important.

You might refer to your discharge instructions. The only element that might pertain was When to contact you physician - New onset of upper back or left shoulder pain.

Here are some links that may be of some help: https://www.bariatricpal.com/topic/249135-sharp-pains-in-left-side/ https://www.bariatricpal.com/topic/193032-pain-under-my-ribs-on-left-side/ https://www.bariatricpal.com/topic/202303-pain-on-my-left-side/

After gastric bypass surgery, I had blood work done once per year to assess any deficiencies that might occur. It is a little like fine tuning a car. After my first annual review it was determined I was iron deficient. As a result I have been taking an additional iron supplement once per day. I am 4 years post op and I would not describe myself as anemic because I have plenty of stamina (ability to perform physical labor). I just have an iron absorption deficiency. A couple more points - it is important to space apart your iron and calcium supplements by at least 2 hours. Because that will affect absorption. According to my nutritionist, if you are taking iron supplements, it should be ferrous sulfate for the best absorption.

Since you are at the beginning of this process, 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.

Debedeb appears to be Debedeb Wilson. [The photo posted for her on bariatricpal matches that used on the gofundme account] Three months ago she set up a gofundme account for Tracy Saville. The following is an excerpt from that fundraiser account: It is so rare that we find someone who is willing to give to others openly and lovingly, someone who acts as an angel among us. However, Tracy Saville is a prime example of just that type of person. A man who gave his entire life to others has fallen and now this angel needs our help. Three months ago Tracy went in for a sugery that should have changed his life for the better. Instead, it turned out to be nightmare that has him fighting for his life. This man has dedicated his life to foster kids, assisting children living in poverty, and he has continuously participated in a big brothers program. Tracy has spent his entire life giving back to others, and now he is in a position where he needs that same generosity and support. When the complications happened it took weeks before he was finally able to get an answer about what was going on; by that time, it was nearly too late. Miraculously, he pulled through a prolonged stay in the hospital and multiple procedures. As he woke to see family around, tears rolled down his cheeks, though even then he managed to crack smile in front of his loved ones as he recieved the bad news and struggles he would face. It was then that he discovered that he had a massive infection that had been neglected for far too long. This would only be the beginning of months spent in the hospital. After another set of failed treatments, he was flown to Jacksonville, Florida to the Mayo Clinic. Finally, he had some great doctors working relentlessly trying to save organs and his life. We are blessed to have him here, but now he is 6 hours away from home. Yesterday, he went in for another surgery as doctors scrambled to clean out the infection and repair many leaks from several places including his stomach and esophagus . More bad news came to him and his family, and we found he would lose half of one of his lungs. The doctors and staff don't understand how he made it through this series of complications and such dangerous conditions, but we of faith know that answer don't we?

I did not know what side effects gabapentin might have, so I looked it up. http://www.rxlist.com/neurontin-side-effects-drug-center.htm Generally speaking, the drug has a lot of bad side effects but weight gain is generally not one of them. In a controlled trial only 2% of patients identified weight gain as a problem. As far as type of surgery, I would probably recommend either gastric bypass, sleeve or duodenal switch. If you have severe acid reflux, I would recommend against the sleeve because the sleeve will only make that condition worse. Although some have success with lap band, many have experienced problems with that procedure. One of the individuals in our bariatric surgery support group, had a lap band, but after several years that band started to erode and eat through his stomach, it became life threatening, so he had it removed and replaced with gastric bypass. For that reason and others, many doctors are no longer performing that type of surgery today.

Many experience problems drinking protein shakes. I hated them. But in the beginning I drank them, three 16-ounce protein shakes a day, in order to meet my protein requirements. You do not have to like protein shakes only tolerate them. There are many varieties of protein shakes available today. Experiment until you can find one you can tolerate. There are many different types of formulations on protein shakes. I would recommend that you keep experimenting until you find one that you can tolerate. You don't have to like it, just tolerate it. I used Muscle Milk Light (Vanilla Creme) powder blended with water and a half a banana. That worked for me. But on the opposite end of the spectrum, you might try premixed Isopure. If you tried all the various varieties and still are unsuccessfully, then there is the fallback of fortified milk. 32 ounces of 1% milk fortified by adding 1 cup of dried milk provides 56 grams of protein. It also takes a dent out of meeting the fluid requirements. Mix up a pitcher and drink a little throughout the day. 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. 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. If you focus on consuming high protein mealst, 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. There are at least two forms of protein supplements: protein shakes and protein bars. Coordinate with you nutritionist to determine when you have a green light to transition to protein bars. It wasn't until the 3rd or 4th month that my nutritionist recommended them. Your stomach may still need a little extra time. A protein bar is probably too dense at the two month mark. I used Quest protein bars. These bars were good in that they had high protein, minimal sugar and also contained fiber. Fiber comes in handy when you are dealing with constipation issues. Quest bars came in a lot of different flavors. Protein bars are good when you are on the go and can't drag along a blender in order to mix a protein shake. A Quest protein bar contains 220 calories and provides 21 grams of protein. A Muscle Milk Light protein [2 scoops of powder in a 16 ounce glass] contains 210 calories and provides 25 grams of protein. So they are comparable.

I hated protein shakes. What worked the best for me was Muscle Milk Light (Vanilla Creme) powder blended with water and a half a banana blended in. Adding the banana gave it some taste.

Congratulations and good luck on your progress post-op.

Good luck on your progress post-op.

Dealing with health insurance companies can be very challenging. Just persevere. 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.

Prior to surgery, I kept a food journal. It was a real eye opener. I could see where my daily diet was getting me in trouble and what to avoid. Before surgery, I had constant hunger. When I was eating a meal, my mind was thinking what I would have for my next meal. It was incessant. Now the interesting thing that occurred after my RNY surgery was that I completely lost my hunger. It was not difficult to plan my minuscule meals because I wasn't really hungry. This condition does not last forever but for about a year and then the hunger returns. It just isn't as strong as before. 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. So after surgery, it is extremely important to follow the surgeon's guidelines on meal volume and acceptable foods. This changes the further you are post-op. But meal planning is less important because you meal volume will be very small. Your taste buds may change after surgery. Protein shakes may be not taste good after surgery. So be willing to experiment until you find one that works for you. You do not have to like the protein shake you select but you must be able to tolerate it. There are many different formulations available. So in answer to your question on meal planning post surgery, the focus should rather be selection of a protein shake that will work for you.

Constipation can be a problem after surgery. Make sure you are drinking the required amount of fluids because this can make you constipated. Several months after surgery I became so constipated I had to resort to using glycerin suppositories. But this was the extreme when you are really bound up. I discovered eating an apple a day just before bedtime corrected the problem. Then generally the next morning produced a bowel movement. But you must eat the skin of the apple along with the pulp. Other remedies suggested by those on this board include: Smooth Move Herbal Tea Prune Juice (warmed) Prunes (4 in the morning and 4 at night) Magnesium citrate Insoluble fibers (Garden of Life Raw Fiber or Renew Life Triple Fiber). Haribo Sugar Free Gummy Bears Aerobic Magnesium 07 Ground Flax Seeds (but don’t try to grind it yourself). Use 2 tablespoons per glass of water every night before going to bed. Bowel Clear (herbal blend)

After surgery, I found that my stamina [the ability to perform physical labor] increased dramatically. I am almost 70 and can work like I was 30. So you will be fine after the first couple months.

According to the internet: A panniculectomy is when a pannus is surgically removed. A pannus is excess skin and adipose tissue, sometimes referred to as an apron that hangs down over ones genitals and/or thighs. This excess tissue can make it difficult to maintain good hygiene in the genital area. I did not have this done. It may also depend on whether you are male or female or how much overweight you started with. You might want to repost this under the forum: Plastic Surgery.

In the morning I put my Citricals in a small finger bowl. Then I take a couple every couple hours. When I am up and about I put them in a zip lock bag and take them with me. For me this is not difficult. Sometimes I take two at once. But right after surgery, I lost my ability to swallow large 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.

After surgery, I remember coughing sometimes. Not really the coughing but the pain associated with the coughing. After a few weeks this was no longer a problem. As Myaiku said, make sure you regularly use your spirometer. Some patients have a tube placed down their throat during the operation. Here is a link to an article that describes the condition and relief from it. https://www.verywell.com/why-does-my-throat-hurt-after-surgery-3157316

I am a big fan of physical labor. To me routine exercise at a gym is valuable time wasted. This is especially true because the nearest gym is an hour and a half drive roundtrip. Exercise includes physical labor. If there is no physical labor available, I generally do hill walking. My driveway is very steep and all I need to do is walk out my door. One of the tasks I worked on during my second and third year post op was building an underground shelter. Tornados struck about 7 years ago, just after I retired. The tornados did a lot of destruction to my property but spared my house. My house is a one story without a basement and there is really no place to take shelter in the event of another tornado. So I decided to build an underground shelter from an intermodal-shipping container into the side of my hill. Of course, if I build a storm shelter, it should also be a root cellar. And if I go to the effort of building a storm shelter/root cellar then why not go through a little extra effort and build it for Come-What-May, including asteroid impacts, nuclear war and nearby supernovas, etc. So during each of those years I moved 100,000 pounds of gravel by hand along with around 60,000 pounds of concrete blocks. This year my wife wanted me to build a playhouse for the grandkids. I decided to build a log playhouse and also get some of the grandkids involved in the effort. It uses 160 landscaping timbers. With the loft, it extends around 16 feet off the ground. I had RNY gastric bypass surgery over 4 years ago. Without the surgery, I could never perform these tasks, especially since I am approaching 70.

The three most important elements after Weight Loss 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 increase the volume 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. The Weight Loss Phase is short and then you will slide naturally into the Maintenance phase. If you want to get the most out of your surgery, it is extremely important to follow the detailed guidelines given to you by your surgeon.