James Marusek

You mentioned two problems: strictures and ulcers. So for a moment let us talk about ulcers. 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. 1. So there is a need to avoid NSAIDs like aspirin or Excedrin. Here is a more complete list of other NSAIDs. Ibuprofen, Diclofenac, Naproxen, Meloxicam, Celecoxib, Indomethacin, Ketorolac, Ketoprofen, Nimesulide, Piroxicam, Etoricoxib, Mefenamic acid, Carprofen, Aspirin/paracetamol/caffeine, Etodolac, Loxoprofen, Nabumetone, Flurbiprofen, Salicylic acid, Aceclofenac, Sulindac, Phenylbutazone, Dexketoprofen, Lornoxicam, Tenoxicam, Diflunisal, Diclofenac/Misoprostol, Flunixin, Benzydamine, Valdecoxib, Oxaprozin, Nepafenac, Etofenamate, Ethenzamide, Naproxen sodium, Dexibuprofen, Diclofenac sodium, Bromfenac, Diclofenac potassium, Fenoprofen, Tolfenamic acid, Tolmetin, Tiaprofenic acid, Lumiracoxib, Phenazone, Salsalate, Felbinac, Hydrocodone/ibuprofen, Fenbufen]. 2. Then there is a need to take antisecretory therapy with proton-pump inhibitors, and/or sucralfate. Proton pump inhibitors include [Omeprazole, Pantoprazole, Esomeprazole, Lansoprazole, Rabeprazole, Dexlansoprazole, Rabeprazole sodium, Pantoprazole sodium, Esomeprazole magnesium, Omeprazole magnesium, Naproxen/Esomeprazole, Esomeprazole sodium, Omeprazole/Bicarbonate ion] and/or sucralfate [Carafate] antacid. You mentioned that you are taking Carafate. As a routine practice, my surgeon prescribed Omeprazole [over the counter Prilosec] to me for the first year to allow my stomach to heal. 3. And finally have yourself tested for H pylori infection. Others on this website have discovered they had this infection and didn't even know it and it was the cause of all their problems. I am not a doctor so take everything that I said with a grain of salt.

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. 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. The Fluid requirement is met by a combination. It is not only the water that you drink each day. But also the water you drink when you take your Vitamins and medicine. It is the milk you drink. It is the fluids content of the Protein shakes. It is the water component of the Soups you take. It is met by flavored water such as Crystal Light. It is met by sugar free popsicles. It is met by tea and decaf coffee. It is a combination of all the fluids that you consume during the day.

I took no pain meds after I left the recovery room. I didn't need to. My pain levels were at most a 1 or 2. Walking every 2 hours in the hospital helps to reduce the gas pains.

The transition to solid food especially meats can be rough. I found the best way to eat chicken was to make it extremely tender. Take a chicken breasts and put it in a covered pot with Water and a bouillon cube and then cook it slow for a couple hours until the meat comes easily apart with a fork.

Sodium is an electrolyte the body needs to help regulate blood pressure and ensure muscle and nerve cells work properly. Normal blood sodium levels fall between 135 and 145 mEq/L. Conditions such as overhydration, burns, diarrhea and vomiting may cause sodium levels to drop below normal, a condition called hyponatremia. Low levels of sodium in the blood may cause symptoms involving muscles in the body. Symptoms include problems such as spasms or cramps. Muscles may experience fatigue easily when a person has low sodium levels. Muscular weakness and seizures are additional signs of a sodium deficiency. http://www.livestrong.com/article/417785-signs-of-sodium-deficiency/ It is important to maintain your bodies electrolytes and sodium is an important electrolyte. Individuals normally consume table salt which provides this sodium or foods that contain salt. My mother went on a no-salt diet after watching too much misleading information on TV. She suffered a variety of symptoms which lead her to the emergency room in the hospital.

I used a Ninja blender to mix my Protein shakes. It had a removable attachments and I found that the single serving cup worked best for me. This is essentially what you are calling a Nutri Ninja Duo using the Nutri Ninja cups. After blending, you remove the cup from the blender turn it over, take off the blending head and screw on the sip and seal lid and you are good to go. Very convenient. Long story short - I would highly recommend it.

After many years of being overweight and then obese, health issues (diabetes, high blood pressure, sleep apnea, GERD) started to take hold of my body. It was like I was in a death spiral. I had RNY gastric bypass surgery 3 years ago and lost significant weight and that put all these health issues into remission. There are trade-offs in life. I traded my love of food for good health. I don't regret it.

I had RNY gastric bypass surgery 3 years ago. Right after the surgery I became lactose intolerant. Whenever I drank milk, my stomach would hurt, then a quick trip to the bathroom with diarrhea. That condition lasted for two months and then I was back to normal. During that time I avoided anything that contained lactose. Some Protein shakes contain lactose.

Good luck on your surgery and check back with us when you are on the other side.

Good luck on your upcoming surgery. After my RNY gastric bypass surgery, I was directed to consume full liquids for the first 4 weeks and then pureed foods for the next four. It was only when I reached week 9 that I could transition to solid foods. During the food transitions I found that transitioning to solid foods was the greatest challenge. There is no need to rush these transitions, just take your time.

After surgery your taste buds may change. This is true for the type of Protein shake you select. So I recommend that you do not stock up on too much in the beginning but be willing to experiment until you find a Protein Shake post-surgery that you can tolerate.

Your weight goal is an artificial number. I had RNY gastric bypass surgery and my weight loss stopped at around 7 months and I transitioned into the maintenance phase. Your weight loss will very naturally get smaller the closer you come to an end of the weight loss phase. I set my goal weight for the high side of normal BMI. This has the lowest mortality rate. You want to have a little extra fat on you in case you encounter a serious illness or accident to help carry you through the recovery process. Being normal is good. Being underweight, overweight or obese has higher mortality rates.

It is common to feel fear prior to surgery. Most people do. This fear could easily be manifested in your dream state.

Shortness of breath is sometimes an indication that you may be having a heart problem. I would suggest you discuss this with your surgical team.

Welcome. 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. Some of the problems that you seem to be encountering could be caused by a lack of Vitamins or a lack of protein. 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 are restricted to is minuscule (2 ounces) per meal. But as you get further along, the meal volume increases. Therefore if you concentrate on consuming high protein meals, you have a very important option available to you. You can start to reduce your reliance on protein supplements. I went from 3 protein shakes per day in the beginning, down to 2, down to 1, and then when my meal volume increased to 1 cup per meal at a year and a half, I was able to completely offload my use of protein shakes. So I think you might want to track how much protein you are consuming from meals daily and if it isn't enough, you may have to add protein shakes or Protein Bars to your daily consumption. After surgery, you should have been given a list of vitamins that you need to take daily. This is an initial list. Normally you had several blood workups since then that measured how well you are doing with your vitamins. If you are below the required levels normally your surgeon changed your daily requirements to bring you back to normal. This is extremely important because the part of your stomach that normally converts food into vitamins has been cut away permanently. Thus you have to take a vitamin mix every day for the rest of your life. You indicated that you bruised easily. For several years I was taking aspirin and as time went on I discovered I was bruising very easily. Aspirin is a blood thinner, so are products that contain aspirin such as excedrin. I stopped taking aspirin and my bruising went away.

Congratulations on your massive weight loss.

I think this problem could be solved by restricting Newbies from posting links. I think what the spammers are doing is to post links so that spiders can pick up the link and position their link high up on the search engine listings. So it is important to permanently remove this spam and not let it sit in the archives of this website. Otherwise this website is inadvertently giving these links credibility. It also seems like this Spam is being generated in India or that region. It generally appears around 2 o'clock (East Coast of the U.S. time) in the morning or thereabouts. And some originators once and a while cite their location as country of origin.

I am a very hard stick also. Generally when I go to have a blood sample taken, the first thing I ask is for a very experienced nurse. Otherwise I cycle through several nurses and many sticks during this process. I am 3 years post-op RNY surgery and one of the unusual effects from this surgery and weight loss is that it seems like this problem goes away after you lose the weight.

I had RNY gastric bypass surgery 3 years ago. I did not notice any hair loss. I believe that as your weight loss phase comes to an end and you transition into the maintenance phase, this hair loss should come to an end and you should experience a regrowth. In my case I transitioned at month 7. Some sleeve patients lose weight at a slower pace and transition up to 2 years after surgery. But this also varies by individual and the amount of weight that someone has to lose. So everyone is different. I used a supplement called Juvenon for many years before and after surgery. It can be purchased on the internet. I suspect this product helped to keep my hair from falling out. The reason why I say this is because I am now 68 years old and about a decade ago long before my weight loss surgery, I was starting to go bald. I began using this product. This supplement stopped that and also gave a little color back to my hair which was turning white at the time.

Congratulations on your upcoming surgery. 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.

There was a recent study on the effects of yo-yo dieting on women. The problem is that I cannot tell what it all means. The results of the study showed that: There was an association between weight cycling — also known as "yo-yo dieting" — and the risk of sudden cardiac death. The increased risk was more than three-fold greater in these cyclers than in weight stable women. Weight cycling by overweight or obese women carried no excess risk of death, however. Similarly, women who reported a maintained weight loss or gain had no increased risk of death. The sample size was large. Lead investigator Dr. Somwail Rasla from Memorial Hospital in Rhode Island analyzed the weight history reported by nearly 160,000 postmenopausal women; follow up was about 11 years. Participants were categorized as underweight, normal-weight, overweight or obese at the start of the study. Then they were further listed as weight cyclers — those who repeatedly lost and regained weight, weight stable, steady weight gainers, and maintained weight loss. But this was a self reporting and thus depended on the accuracy and truthfulness of participants' reports. So it is not the most reliable type of study. http://acsh.org/news/2016/11/17/normal-weight-women-avoid-yo-yo-dieting-10451 I guess if I could interpret this, it might be Some Fad Diets are Dangerous, Very Dangerous.

When I wrote this I said these accidents "may have been due" to sleep apnea. Blaming sleep apnea may be a "deflect the blame" tactic. There are many components of sleep apnea. Snoring is one and dozing off is another. My family noticed that I was sometimes dozing off when I was with my family. In part, there was a voluntary component to this. If the conversation was not interesting, I might allow myself to relax and doze off. But when I was driving, this never happened because I was very focused on driving and stimulating my senses to prevent this from happening. Sometimes when it was cold I would even open the window to allow fresh cold biting wind to energize me, or I might tap my foot, or listen to the beat of music. I would fight the impulse. So I think that it is too simplistic to blame sleep apnea on these accidents without laying some of the blame on the train conductor. If he needed help to stay alert, it was his responsibility to seek that help and resolve the issue prior to the accident.

Prior to my RNY gastric bypass surgery 3 years ago, I had sleep apnea. At night I would keep my wife awake all night long with my snoring. After surgery this condition went into remission and stayed there. I would wake up in the middle of the night and find my wife hovering over me. I asked her what she was doing. She said I was sleeping so quietly she was trying to find out if I was still alive. I came across an article today called Engineer in NJ Transit crash had undiagnosed sleep apnea, officials say that points to one of the dangers of sleep apnea. The article says that the 29 September 2016 commuter train crash that killed 1 and injured 108 people in Hoboken, New Jersey and also the 1 December 2013 commuter train crash that killed 4 and injured 63 people in New York may have been due to the conductors suffering from undiagnosed sleep apnea. I guess I always put sleep apnea in the box of snoring but I wonder how many lives are lost when drivers temporarily fall asleep at the wheel, or train conductors at the controls of the engine, or ship pilots at the helm. http://www.foxnews.com/us/2016/11/16/engineer-in-nj-transit-crash-had-undiagnosed-sleep-apnea-officials-say.html

I am over 3 years post-op RNY gastric bypass surgery. Because of this type of surgery, I take many more Vitamins than a patient that has undergone sleeve surgery. After surgery I found that I could no longer swallow large pills. This made taking vitamins a difficult challenge. This condition lasted about 2 months and then I was able to swallow again. Vitamins should not all be taken at once. They need to be spaced out throughout the day otherwise they are not absorbed properly. There should also be a time separation of at least 2 hours between Iron supplements (as found in multivitamins) and calcium supplements. They should not be taken together. I do not swallow all my vitamins at once. I do not fill my mouth with 3 vitamins and then drink Water. I do these one at a time. In my case because I have so many to take, I use the following approach. I place all my calciums in a small glass bowl each morning. These I take throughout the day a couple hours apart. All the other vitamins I divide into two weekly pill containers. One for the early morning and one for the late evening just before bedtime. Since these are weekly containers (14 small compartments), the fill covers a two week period for each container.

There is a saying "Never trust a fart." After RNY gastric bypass surgery, I fart perhaps twice as much post surgery as pre-surgery. This is especially bad in the beginning. For the first few weeks after surgery, this was sometimes more than just a fart. Therefore it is probably not a bad idea to have an extra change of underwear, just in case. But this particular phase does not last long and then your farts turn back into farts.