James Marusek

I never vomited blood. I knew someone who coughed up a lot of blood. I rushed the person to the emergency ward only to be told it was not a problem. In this case the person had a nose bleed. It was night and in a horizontal position the blood started to collect in their lungs and they coughed up a lot. It seemed pretty scary at the time. Sometimes during an operation, they insert a tube down your throat. This might make the area raw and might tend to bleed.

Work this through your nutritionist. Call their office today and inform them that you are pregnant and seek advice.

Right after surgery, your body is in a major heal mode for a couple weeks and it is difficult for some patients to meet their daily Fluid and Protein requirements. But keep trying each day and you should be able to get there. The three most important elements after 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 RNY gastric bypass 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.

It can be rough in the beginning, but it does improve dramatically as time rolls on. 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 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. It is common for your taste buds to change after surgery. I remember in the hospital after surgery I could not drink the Water because it tasted very chlorinated. Eventually I found flavored water such as Crystal Light to work O.K. 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. Over time as your meal volume increases, if you concentrate on consuming high protein meals, you can begin to reduce your reliance on protein shakes.

From the time that I began the process for bariatric surgery until I had the surgery, it took around 9 or 10 months. So you may want to factor that into your decision process. Maybe you should have the band removed in your current state and then start the process of moving. Some insurances will cover one type of bariatric surgery but not another. So you may want to research this also.

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

It’s pretty widely known that chronic over-indulgence in alcoholic beverages can play havoc with one’s liver — in extreme cases ending up with cirrhosis and a non-functioning organ. But non-drinkers can also have liver problems. In particular, there is one called non-alcoholic fatty liver disease, or NAFLD, which is a risk factor for chronic liver disease and cardiovascular disease, according to the authors of a recent report in JAMA Internal Medicine. NAFLD is a condition in which triglycerides (fats) accumulate within liver cells. If the accumulation is extensive enough it can trigger inflammation and a condition known as steatosis, which can then progress to irreversible cirrhosis. The authors of the report conducted a randomized clinical trial to investigate the effects of different levels of exercise on NAFLD in obese Chinese adults. Led by Dr. Hui-Jie Zhang from the First Affiliated Hospital of Xiamen University, Xiamen, China, they randomly assigned 220 adults (40-65 years of age) with abdominal obesity and NAFLD – documented by MRI – to one of three exercise conditions. They were particularly interested in ascertaining whether vigorous versus moderate exercise differently affect NAFLD. The three groups were: VM: vigorous exercise for 6 months followed by moderate exercise for 6 months. M: moderate exercise for 12 months C: control — no exercise program. The authors concluded “Vigorous and moderate exercise were equally effective in reducing intra-hepatic triglyceride content; the effect appeared to be largely mediated by weight loss.” http://acsh.org/news/2016/08/23/exercise-could-save-your-liver/ So I guess the bottom line is that if you lose weight and exercise, you can repair some of the damage to your liver, prevent cirrhosis and live a longer healthier life.

Good luck on your upcoming surgery and let us know if we can be of any help.

There are two phases to weight loss surgery. The first is called the weight loss phase and the second is the maintenance phase. I had RNY gastric bypass surgery three years ago and I transitioned from the weight loss phase to maintenance at around 7 months. Sleeve patients tend to lose weight at a slower pace but can sustain the weight loss for a longer period of time. Sometimes 2 years. Weight loss is achieved by meal volume control. As your meal volume increased after surgery, if you concentrated on consuming high protein meals, then you can offload some of the protein supplements (protein shakes, protein bars) and the extra calories that they contain. This is how I broke some of my weight loss stalls. Here is my perception of the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

There may be two things at play here. First, as your fat cells dissolve they will release not only fat but also hormones and chemicals stored within these cells. Generally these are flushed through your system into your kidneys and expelled in your urine. But it is very important to make sure you are hydrated. If you do not drink enough fluids, these hormones will stay in your system and you will experience a hormonal flush. Second, your new stomach may not absorb your prescription medicine the same way that it did prior to surgery. You may have to work with your doctor to find a medicine that will absorb better.

I had RNY gastric bypass 3 years ago. My regiment was fairly strict. There are other types of surgery such as mini-gastric bypass that some individuals had done and it seems like their post-op direction is very different than RNY. 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 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. I think my daily caloric intake during the first several weeks after surgery was in the range of 500-600 calories. That includes the calories in the protein shakes. At 3 weeks out I was not allowed soft foods including Pasta, rice, crackers and toast and too many carbs are a big no no. The primary focus on food was to alway put protein first.

Good luck on your upcoming surgery. It is common to be nervous before an operation. I am not sure what you mean by blue stain on their face. I don't remember any. But maybe I wasn't focused on the way I looked after surgery. I think my only focus was not to reveal too much wearing a hospital gown, that is somewhat open in the back. This was especially true when I walked the corridors of the hospital once every two hours.

Some people experience strictures and this can make it difficult. At 4 weeks post-op, you might be experiencing one of these. Since you can't even keep Vitamins down, this might be a cause. Your taste buds generally change after surgery. This can make Protein shakes difficult to drink. But experimentation is the key. Just keep trying all the different options available until you can find one you can tolerate. You don't have to like it, just tolerate it.

Keep doing what you are doing. Stay hydrated and walk, walk, walk. It will get better.

​A group from Scotland’s University for Sporting Excellence found no difference in the muscle growth response to protein after a full-body resistance training workout between more muscular and smaller participants. Except when it came to specific exercises. The study split young, resistance-trained males into two groups; those with lower lean body mass (<less than 65 kilograms) and higher lean body mass, 70 kilograms and higher. Each volunteer participated in two trials where they consumed protein after resistance exercise. In one trial participants consumed 20 grams of whey protein and in the second, they consumed 40 grams of whey protein after exercise. Scientists measured the muscle’s ability to grow at an increased rate with metabolic tracers and muscle biopsies. The amount of muscle worked in a single session has a bigger impact on the amount of protein needed afterwards, than the amount of muscle in the body.” If you’re just doing legs and weights, more protein may not matter, but if the exercise is whole-body resistance exercise, more is better. http://acsh.org/news/2016/08/22/do-men-with-more-muscle-need-more-protein/

In RNY surgery, weight loss is achieved through 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. As your meal volume increases, you have an option to extend the period of weight loss. Assess your protein intake. Your protein requirement is met by a combination of the protein from your meals combined with the protein from your supplements (protein shakes, protein bars). Since your meal volume is beginning to increase, that also means that the amount of protein from meals is increasing, especially if you concentrate on consuming high protein meals. Therefore you could be able to reduce your reliance on protein supplements and the calories they contain. I went from 3 protein shakes a day, down to 2, then 1 and finally zero when my meal volume increased to 1 cup per meal at a year and a half. This was how I dealt with several stalls along the way.

Isn't it great! I went from a size 3X down to a size Small in shirts and from a size 46 down to a size 33 in pants. Before I couldn't even shop in many department stores because their sizes stopped at 2X. Now a whole new world opened up. I replaced my entire wardrobe with up to date fashions. Generally I am a bargain shopper. It is like being a treasure hunter. I purchase clothes at 70-80 percent off retail. The major problem is that my closets are completely full of new clothes and it is hard to turn off the bargain shopping switch.

I had diabetes prior to RNY gastric bypass surgery 3 years ago and I was taking 2 types of medicine to control it. And even at that, it was starting to get out of control and my doctor was advising that I transition to insulin shots. By the time I left the hospital 2 days after surgery, my blood sugar was no longer a problem. I went off all my diabetes meds and this condition has been in remission ever since. After surgery, I am focused on minimizing any processed sugar in my diet. Sugar is my kryptonite. I have found that there are artificial sweeteners such as Splenda and natural low calorie sweeteners such as Stevia that keep my sweet tooth in check. Many of these are now integrated into many products in the grocery store. So I read labels a lot. To me the logic is simple - generally, you cannot get high blood sugar if you eat no processed sugar in its many forms.

Congratulations.

Congratulations.

Anaphylaxis (anaphylactic shock) is an acute, potentially fatal, multiorgan system reaction caused by the release of chemical mediators from mast cells and basophils. The classic form involves prior sensitization to an allergen with later re-exposure, producing symptoms via an immunologic mechanism. An example might be a bee sting. So you might have an allergic reaction to one of the medicines that you are taking. Have you localized which medicine is causing the problem? Shortly after my RNY gastric bypass surgery 3 years ago, I was off all my high blood pressure medicines and diabetes medicines. So my surgery caused me to take fewer meds than before.

Congratulations. Looking good!

In general, some of your skin will contract during the first year after surgery. Exercising can help. So you might incorporate exercise the use the muscles in your arms into you daily exercise routine.

Many patients find it difficult to meet their daily Fluid and Protein requirements right after surgery. That is because their body is in a major heal mode. So just keep trying and you should get there within the next few weeks. Many individuals experience changes in the way things taste and smell after surgery. This can make it difficult for some to drink their Protein shakes. It is important that you be able to tolerate protein shakes. You do not have to like it, only tolerate it. I hate the taste of protein shakes. But I did some experimentation until I found something I could tolerate. In the end, I found that I could drink Muscle Milk Light (vanilla Creme) Protein shake powder blended with Water with a half a banana. That was what I could tolerate. But there are many choices out there, many different compositions. If you try them all and still cannot find one you can tolerate then another option is to drink fortified milk. 32 ounces of 1% milk fortified with 1 cup of powdered milk will give you 56 grams of protein. You can mix up a pitcher and drink a little at a time throughout the entire day.

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. In general the requirement for liquid intake is 64-80 ounces per day. But many things count towards this total. It is Water and milk. It is the liquid in the Protein shakes. It is the water you drink when you take the various Vitamins and meds throughout the day. It is the water content of Soups. It is tea, decaf coffee, Crystal Light flavored drinks, etc. So it is generally not hard to reach this goal. The protein requirement is generally 75-90 grams of protein per day. Weight loss is achieved after surgery through 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. Later after a month or two you can add Protein Bars as an option in meeting your protein goals.