James Marusek

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. Also stress can cause weight gain. So the recommendation to stay off the scale may be appropriate.

Where are you at in the process? Pre-op, post-op, how long? Sounds a little like dumping syndrome.

Most of this computer spam [spam is considered to be electronic junk mail or junk newsgroup postings. Some people define spam even more generally as any unsolicited email.] is generated from Pakistan and India. My count so far from the 15 spam threads I observed is Pakistan-13, India-2.

I didn't experience any knee pain. But at night I did experience leg cramps. [A muscle cramp is a strong, painful contraction or tightening of a muscle that comes on suddenly and lasts from a few seconds to several minutes. It often occurs in the legs. A muscle cramp is also called a charley horse. Nighttime leg cramps are usually sudden spasms, or tightening, of muscles in the calf.] Several threads report this condition was common after surgery. It can be caused by dehydration and also by a deficiency in vitamins/ minerals (Calcium, potassium).

The hardest pill for me to swallow was the Calcium supplements (Citrical). These were large pills and after surgery, I could not swallow these so I resorted to crushing them. But swallowing these in Water tasted like chalk. Eventually I found out that I could crush them and add them to Crystal Light drink to mask the taste. I would stir up the drink and swallow it down. But there was always some paste left over at the bottom of the glass, so I would add some more drink, stir it up again and swallow that down. By the third time, I generally consumed the calcium. Luckily this stage does not last forever. After about 2 months I found out that I could swallow again and the problem was solved.

It is common to hit stalls along the way. So just keep meeting the program requirements, be patient and watch the pounds melt away.

You are 1 month out from surgery and you are showing a weight loss of 57.8 pounds. How much of that is pre-op?

I will pray that your surgery goes well. Check back with us when you are on the other side.

After RNY gastric bypass surgery, the part of your stomach that process fats and sugars has been cut away. So if you consume either of these substances, this leads to dumping syndrome. But after many months, your intestines realize something is amiss and evolves to take up the slack. You body transforms. Therefore after this time, you stop dumping.

My surgeon's directions were to not start your Protein supplements until day 5 after surgery or until you have passed gas. The advise from different surgeons will differ. It is common for individuals to not meet their protein requirements at the very beginning because their stomachs are in a major heal mode. But since your surgery was on 11 November, I think you are far enough along to experiment with the various Protein shakes until you find one that you can tolerate.

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 my RNY surgery, my weight loss tapered off and came to a natural plateau at 7 months. At your stage loosing 2-4 pounds per week, in my opinion doesn't seem too drastic. Right after my surgery, I was losing 2 pounds a day at the beginning. I am 5 foot 6 inches tall like yourself but I am a male. I went down to 143 at my lowest weight. In your case you might actual get down to 130 pounds before leveling off. So make sure that you are getting in your required protein, fluids, Vitamins, 30 minutes of walking each day or equivalent, and the specified meal volume and try not to worry too much.

You might not want to use this post-op because it contains caffeine. According to the internet the shake contains 110 calories, 2 grams sugar and 15 grams Protein, which seems O.K. pre-op.

I had RNY gastric bypass surgery 3 years ago. One of the first changes I made was to give up my 6 diet coke a year habit. One of the requirements of the program was to stop consuming caffeine and carbonated beverages. So I decided to do this early. I lost 20 pounds on that change alone. But be forewarned. I suffered through a week of severe caffeine withdrawal (severe headaches and body aches) when I went cold turkey. Another thing you could do is to restrict yourself from drinking any fluids when you eat a meal. Drinking fluids during a meal allows you to consume more food. Another change you could make is to restrict you intake from processed sugar. Substitute artificial sugar such as Splenda or natural low calorie sugar such as Stevia in its place.

Congratulations.

I read an interesting article on Fiber today and I am still trying to absorb it. Some of the key points are: It is important to consume a minimum of 25-30 grams of fiber per day. It should be a natural fiber from real plant food rather than processed or refined fiber produced industrially like inulin powder. We have a massive microbe community that live mainly in our lower intestines (colon). These microbes line the wall of our gut and their numbers reach generally 100 trillion microbes. These microbes digest high fiber foods (that we cannot) and extract the key nutrients. Humans produce around 17 digestive enzymes while microbes have thousands. These microbes (mainly bacteria but also viruses and fungi) have co-evolved with us and produce many of our Vitamins, hormones and chemicals. They are also key to regulating our immune systems, weight and mood. Here is a link to the article. Beans, Chickpeas, Lima Beans, Split Peas, Lentils, Nuts, Flax Seeds, Chia Seeds and Quinoa.]

Strictures are not the only cause of nausea and vomiting after surgery. According to the internet: Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and noncompliance with a gastroplasty diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%. Although no unifying explanation for the etiology of anastomotic ulcers exists, most experts agree that the pathogenesis is likely multifactorial. These ulcers are thought to be due to a combination of preserved acid secretion in the pouch, tension from the Roux limb, ischemia from the operation, nonsteroidal anti-inflammatory drug (NSAID) use, and perhaps Helicobacter pylori infection. Evidence suggests that little acid is secreted in the gastric bypass pouch; however, staple line dehiscence may lead to excessive acid bathing of the anastomosis. Treatment for both marginal ulcers and stomal ulcers should include avoidance of NSAIDs, antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition, H pylori infection should be identified and treated, if present.

After my RNY gastric bypass surgery, I walked 30 minutes each day. This is the recommended amount. Before surgery I would get hot, sweaty and get a little winded doing this exercise. At 2 weeks post-op, my body was performing much like it did during pre-op. Now I am 3 years post-op, and my body is performing very differently.

After RNY gastric bypass surgery, I relied primarily on chili and Soups that I made myself. The recipes are contained at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf

After my RNY gastric bypass surgery, I found that soft foods (such as chili and soups) went down much easier than hard foods (such as a piece of chicken or a steak). So this is what I relied on. Generally I cooked up a pot of chili or Soup and then removed some from a bowl stored in the refrigerator and microwaved it until it was hot. The problem I encountered, especially with reheating chili was that it exploded and splattered the inside of the microwave. I then found a ceramic bowl with a soft lid that contained a vent. This heated my meals well and at the same time meant that I was not constantly cleaning the inside of the microwave. So if you want to try this approach, you might refer to a short article that I wrote that described this and I also included recipes at the end. http://www.breadandbutterscience.com/Surgery.pdf

Hair loss should come to an end and regrowth start near the end of the weight loss phase as you slide into the maintenance phase.

Generally it does get much better over time. But it won't happen overnight. It took me around 6 months to reach a happy state when all the problems seemed to melt away. It is important to walk around 30 minutes each day. It will dramatically help with the healing, recovery and relieving the pain.

As you lose weight, the chemicals and hormones that were stored in your fat cells are being released into your body. These will pass through your kidneys and are expelled in your urine. But they can generate a flush of hormones during the weight loss phase. They should simmer down once you transition into maintenance. It is important to meet your daily Fluid requirements, because it take fluids to flush these hormones from your system.

This website gets hit with quite a bit of Spam posts. Generally it is from first time posters. Since the IP addresses were provided, I decided to take a quick look to find out where it was coming from. Of the 6 posts that I looked at that were Spam, five originated from Pakistan and one from India (New Delhi).

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

Some individuals find it difficult to meet the daily requirements after surgery. This is because your stomach needs time to heal and this can take a couple weeks or more. But just keep trying and you should be able to get there. 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. Be willing to experiment. After surgery, my taste buds changed dramatically. Even Water changed. In the hospital it tasted excessively chlorinated and I could not drink it. So I experimented. sugar free popsicles became my best friend. Some individuals find hot or cold can help with fluids. For me, I found that I could tolerate flavored water. So I began using Crystal Light. I also found a new drink Bai which I liked cold. In the winter, I found that I tolerate Hot drinks such as piping hot cocoa. But you have to use the "No Sugar Added" variety. Also fine English teas were very good.