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I have definitely had the hungry/not hungry feeling since surgery, so I totally get where you are coming from @Arabesque! 🥰 Anything too greasy has been completely unpalatable. I am very thankful I tolerate protein bars and shakes or I would be in a bad place for getting enough protein. I know I need protein to heal, but meat has not sounded good at all since surgery. We had dinner at some friends’ house last week. They served salmon and flank steak. I only manage a couple bites of the steak and gave the rest to Husband. I managed about 2 ounces of the salmon. 🤷‍♀️ I bought a jar of no stir peanut butter to keep at work to eat with fruit. The fat and protein should help with the reactive hypoglycemia to stabilize my blood sugar from the fruit. 🤞🏻🤞🏻I also have walnuts, sunflower seeds, pumpkin seeds, dips, cheeses. I already use high protein milk for my protein shakes, so they are protein packed. My goal is to maintain my weight at 130-135. I need to gain a pound 🤣🤣 I plan to start working out as soon as I am healed, which will help with appetite, but conversely burn those extra calories. 🤦🏼‍♀️🤷‍♀️ So many skinny girl problems! 🤣😂🤣

Hi, I'm having my surgery on the 24th as well. I'm in my preop diet stage. Have you tried many liquids or have you just stuck with the Protein shakes and Water? Sent from my SPH-L720 using the BariatricPal App I start my pre op Monday and I'm allowed 3-4 Protein Shakes a day, pkus no fat broths, sugar free popsicles and Jello tea drinks. I plan on utilizing everything except jello. I'm insulin dependent diabetics so they are concerned about hypo attacks but we have a plan in place.

Prior to surgery I had Idiopathic hyperhidrosis, or excessive sweating for several years. Shortly after surgery this condition went away. I am now 5 years post-op and that condition is no longer a problem. This weblink list 10 causes of night sweats. http://www.activebeat.co/your-health/10-common-medical-causes-of-night-sweats/ #4 and #10 look interesting. Do you have other symptoms that pair with these conditions. Many people develop a condition called reactive hypoglycemia after bariatric surgery.

I am one of ones here that can honestly remember being both skinny at 5'9" 112 pounds---I was skin and bones, not much muscle---just skinny. It was not intentional---it is how I was. I ate everything in sight, and never gained an ounce. I fought like crazy to gain up to 123 pounds so my wedding gown fit! Then I had a baby---and for the first time ever I gained weight. I went home in jeans I wore before the baby. But it soon ended! When I stopped nursing, I was hospitalized for a mastitis infection that hit my blood stream and caused sepsis---I gained 80 pounds in 3 months time! Seriously! I was not eating different. It was extreme! From there I went through bad marriage, abuse, and more serious weight gain! Ironically---some of it totally intentional! (shaking head at self here!!!) Before long, the weight was totally out of control. I could lose pretty well, but it would not stay off. Then it got to where losing so much as a pound took weeks of HARD work---and even then any semblence of normalcy and it come back! I found myself facing very close to 300 pounds, and being morbidly obese. In the time since being banded, I have had to have most of my thyroid removed, and in the medical processes for that, I learned that the inability to gain when I was younger was my first sign of thyroid trouble----and the hormone change of pregnancy, and sudden cessation of nursing, flipped the switch he said from hypo- to hyper thyroidism. Not an excuse, but an explanation---it was pretty scary to be young and out of control like that. But with no insurance, I had no real options for figuring things out. Both extremes, as well as the years I spent in the middle, at a normal weight are both well in my mind, and I can say without a doubt....no questions ask--------morbid obesity brought with it much, much more personal heartache, peoples cruel comments, and open disgust from not only yourself, but even medical personel! I do remember being told I needed to gain a few pounds--by assorted relatives I seldom saw and a Dr. None of which saw me eat! More people by far were envious of how I could eat without consequences---and for the most part I ate healthy enough, just more than you would imagine for remaining so bony! My hip bones jutted out so far, I would have to sew the front pockets of my jeans closed, because the white pocket was forced out and showed! I could have ---not based on looks, but on build---beenon any magazine cover with todays stars....I was EXTREMELY thin---I referred to myself as skinny. The word did not bother me then, nor does it now. None of it compares to morbid obesity. I do not mean to be argumentive Jachut----but as I went up the scale--it got worse the higher I got. The heavier I got, the more invisible I got to parts of society, and the more others thought they could say hateful things without issue! Every single thing you have health wise, is an easy call for a Dr. It is all due to your weight! Until you have felt/heard others talk about you based on nothing but your weight...had a room fall silent when you walked in, simply because they were staring, then jerking their heads away---seen them share looks with who they were with--or been "mooed" at, (and these just a few among many, many ways people find to be cruel) morbid obesity has not touched your life. These did not all happen to me, but I have read about them right here at LBT. I have read the pain involved in each of the situations---and experienced similar things personally, or similar enough situations to know the shame, the hurt, and even the anger they invoked. Should I have gotten control much earlier, of course! I am willing to bet most of us by far wish we had found help before reaching the morbidly obese category. For many of us it didn't come until further down the path of obesity though. Depression, lack of funds, lack of availability all figure into the issue--but having seen and lived from one end of the spectrum to the other----I do believe that unless one has lived and experienced morbid obesity, it is hard to understand or explain. I also believe it is hard to explain to someone in that position (obesity in general) how much better life is, or how much better they will FEEL---at a normal healthy weight. I am quite sure it is difficult for both to see or understand the other --obese vs. thin- without ever walking in those shoes. I think we all want to be accepted where we are--not just at where we want to be. Whether we all strive to be a perfect BMI, or if we are happy elsewhere, if we are working hard where we are, or if we have arrived at goal, and are thrilled with the newfound freedoms of not trying to lose weight still, we all just want to be accepted and have our efforts recognized. Belittling one another, whichever direction it goes is really kind of sad, and usually indicates an unhappiness in ourselves. My experiences show that people usually tear others down in an effort to build themselves up. Maybe the next LBT banner needs to be our own Dove commercial---but without me!!!! LOL Kat

I would love to go vegetarian but am highly reactive to soy which is problematic to meeting Protein goals. Any suggestions from the vegans? Sent from my iPad using the BariatricPal App

No but I do have PCOS and endometriosis and I am insulin resistant. I used to be Hypo thyroid and right around surgery it was fine and I am due for my blood test because it changes often so I might have to go back on meds for that (my dr took me off ) if its out of balance now.

I was connected to sliding scales with insulin pump in hospital. My insulin was monitored by my diabetic consultant. My rates dramatically changed after operation. No complication post op! No problems with infections. No leaks. Had a test 6 weeks after my op. All was good. Left hospital 48 hours after surgery. Weight loss was spectacular in the first 6-8 months. It slowed down later on but with help from yoga and pilates classes plus lots of walking body shape is continuously changing, for better! Took me up to 4-6 month to up my energy levels. Problem mostly with finding a correct balance between carbs an proteins. Not enough carbs means very tired and slowing down with a weight loss. You will soon learn by trial and error! Had a great support from my pump clinic: meeting with my nurse every month to change my pump's settings. Insulin resistance "vanished" after 6 months!!!! Wonderful! Today, over 2 years after my surgery, I'm nice UK size 16. I'm full of energy and my body is still changing shape. I eat absolutely everything in small portions.I eat in public places and attend dinner parties. I don't advertise that I had VSG. It's my business only! When pushed and questioned: "have some more" I very firmly respond- "no, thank you". No explanation added. I love my life and wish I had this done years ago. No bigger problems with hypos now than before sleeve if anything situation is better. Good luck!

Hi There again. I'll let Betsy speak to the malabsorption amount in RNY. All I really know is, it is a fact that there is more in RNY than there is for LAP-BAND as we absorb everything we eat :smile2: You ask what I would do? I would keep pursuing a diagnosis, that is for certain. I'd also pursue the band. This is my opinion only, of course--I have no medical training. The reason I'd choose the band over the other WLS procedures is that you are unsure of your thyroid condition. I would not want to permanently disable parts of my digestive tract. RNY -is- reversible, just not as easily as is a band. Also, RNY affects some other hormones, not sure if I'd really want that if I were already having endocrine problems. My thinking is that if you do get a band, whey you are hypo, you'll not really lose weight, you might even gain. When hyper, the band will help you with portion control and you'll lose, probably pretty quickly. Especially if you work the band properly. This is based on my hyper phase experience. I was HUNGRY. So I ate. Question for you, are the surgeons willing to do the band with the thyroid issues going on? Have you tried Armour thyroid? I've read that some people do much better converting it than the synthetic variety. Best wishes in your decision!

thank you both for the comments! nice to know people are reading my musings @Stella S thanks mama and congratulations on maintenance! @MiniGastricBypassDude thank you! i find it easy to maintain late 170s no problem i did for over a year. i actually would like to drop pounds and get to say 160 if i dont look too small. im about 5'8 and around 180 i look pretty normal. wearing a US 8 or UK 12 in jeans and US6/UK10 on tops. i often crave popcorn and i think thats to do with zinc. cookie dough currently because there is a chocolate orange version i saw and chocolate orange is my absolute favorite LOL. Yesterday i went running, and then just ran errands with my friend, i havent brought a new scale or been able to locate a battery so just really thinking about what i am eating and physical activity. im sure calories came in at about 1300, so i do need to watch it more. I have a friends birthday tonight and will be drinking. my day should look like 2 protein shakes, 2 cocktails, and small amounts of what i want to eat, im off to Hakkasan! i think from monday i will stop eating at 7pm, also want to reach out to my GP as i think i might be reactive hypoglycemic,

It might be related to low blood sugar, especially since you drank some orange juice and it stopped. If you had diabetes prior to surgery and were taking prescription medicine prior to surgery, it may be time to scale back the use of this medicine. It might be signs of a condition called reactive hypoglycemia. Here are a couple links. https://www.stjoes.ca/patients-visitors/patient-education/f-j/PD 7972 Reactive Hypoglycemia after Bariatric Surgery.pdf https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/

Ok, so now you know you are prone to blood sugar problems, and what it feels like when yours gets too low. Make sure to keep "emergency" juice on hand (individually packaged singles are great since they can just stay in your cabinet or fridge until you need them). Try to eat more often through the day to help keep things stable. And always follow your juice with a protein based meal so you don't develop the reactive hypoglycemia. Your doctor will want to know you are having this issue, and can help you know what else you should be doing (changing meds, start testing blood sugar, etc.). Good luck!

I was diagnosed with hypo at 10 years old. Weight has been a struggle all my life. I've been on Synthyroid (levo), Cytomel (lio), Armour and a combo of Synthyroid and Cytomel (best imo). In 2019, I had been on only Cytomel for 3 years and had heart, liver and kidney failure caused by Cytomel (lio) toxicity. It had been eating away muscle including my heart. When I was taken to the ER, my heart rate was 20 and they couldn't get a temperature because I had hypothermia. I was in my 30's, btw with no prior health concerns other than hypothyroidism. I believe it was made worse because I thought I had a virus for 3 days but my heart was failing. I went into a myxadema coma. After 11 days in ICU and 3 weeks in the hospital, I couldn't lose weight to save my life. After trying to lose for 8 months, my Endocrinologist recommend sleeve surgery. My loss has not been as fast as many on this board. I had surgery in July and my pre-surgery weight was 208 at 5'5". Pre-surgery diet was only a week long and I may have lost a few pounds. Since surgery I have lost about 56 pounds. My surgeon is fine with my loss. He says to hit protein and water goals but don't go below 1200 calories and eat whatever you want (after post-surgery diet, of course). I suppose I feel that surgery is pointless if I have to starve and restrict. I've done that most my life. I know many don't agree with that and I understand why. I found my tastebuds changed and sweets aren't as important as they were pre-surgery. I hope to meet my goal by 1 year. My periods have been lasting 2+ weeks and are super heavy so now I'm anemic and I'm sure it hasn't helped my weight loss. I am having a DNC soon to see if there is an underlying reason for all the blood. I can't be on normal birth control due to my heart. I went for an echocardiogram this past week and it came back normal! Considering I had cardiomyopathy, a temporary pacemaker, kidney dialysis, and liver failure less than 2 years ago (in my 30s lol), I am happy with my progress. I think having surgery with hypothyroidism is worth it.

Give it time. It took me about 3 weeks with the gel, and then it wore off because it's a temporary solution to a life long problem, and I was given a vial of Test. cyp and the doors of heaven were opened! If you guys aren't getting pinned for T, and using the gel, I'd recommend talking to your doctor about injections instead. It's a more stable delivery platform and it's easier to manage doses to make sure you're not on a roller coaster ride of T. Plus, why get on T therapy if you're gonna have to worry about your wife getting a mustache because you got sweaty bumping uglies and it reactivated the gel.

I was diagnosed with Graves in 2005. For a while I was a looser with Graves, then it turned and i gained. I was treated with RAI and went total hypo. It has taken years for the synthetic replacement to level off. I gained a bunch my weight post RAI. 40+, which they said shouldn't happen once my thyroid is balanced. If you are gaining with graves and treat it, you will probably gain if you get RAI. Graves sucks either way because you can only treat the symptoms not the disease. So even if you treat the thyroid, you can still get all the wacky autoimmune effects. Like hives, etc. I think if you are healthy, and thyroid is under control, you will be able to get the band. In my opinion, the sooner you start the journey, the better. Good luck!!!!

Michelle - I'm not sure what causes a port infection once the intial healing has completed when erosion is NOT involved. One would have to think it must have something to do with fills, since the materials are inert and supposed to be non-reactive. Although if someone is having problems with the port suturing, like when I tore mine, I wouldn't have been surprised if it had gotten infected, since obviously I had done some internal damage. I don't know much about bacteria living inside of the body, waiting for damage - would that have to be introduced from outside, like with the fill needle? Penni? Any insight into this phenomonen? I do not have any stats as to how often port infections occur, but I do know they are considered to be one of the more common problems (next to vomiting and reflux). As long as your doc is following proper sanitary protocol, there should be a very low risk of infection from fills. But I think the caveat is there is always a risk - it's just not very high. As far as symptoms, I am assuming the area become red, hot, and tender to the touch. Maybe there is an eruption through the skin as well in severe cases? If you have one, you will know. I would not worry too much about this possibility. There does seem to be a rash of them lately, though. :sick

@@rose1504 Definitely get your Thyroid checked, and not just TSH and T4, but T3 as well. I have Graves Disease (autoimmune thyroid disease), this kept me slim my whole life, till 2014 when it did 180 degree turn, and I was piling on weight at a frightening speed. I went from 60kg to 101kg between 2014 and March 2016. I also developed astonishing sweet cravings during that time, which made a mess of me. Graves is Hyper-thyroid. I had every symptom of this disease, except of bulging eyes and goitre. There is also Hypo-thyroid (under-active), Hashimotos etc which also can really mess with metabolism and general well being. Good luck @@rose1504 I hope you don't have thyroid disease, as I wouldn't wish it on my worst enemy ...... Had my both ear Daiths pierced 3 weeks ago, to see if they would help my thyroid migraines and severe headaches. They (the acupressure point piercings) helped me tremendously! I was living almost daily on very strong pain killers. Now, I don't take them, and so those piercings really helped me. I have a huge stock of heavy duty pain killers at home, and now I forget all about them. So, Good Luck with all your tests. Please let us know how you went.

Mommy202... yes, I have lost 80 lbs 4 times in my adult life... the last 3 were adhering to a strict low carb diet. I have hypo thyroid and PCOS.. so for me the Low Carb is what helped SO MANY things..... but something would happen and I would go off plan and then it would spiral til I was all the way back up and this last time was no exception..... I have thought long and hard about the band, and it took me a year of debating it in my head before I really decided to go for it. I was really ticked off that I just couldn't maintain a loss on my own. So, for ME I view the band as a FORCED committment to a LC way of eating WOE. Protein First, Veggies Second, Carb 3rd....... Yes, I know I will be able to eat around the band, but I KNOW what my body needs.. so I believe I will be fine.. most of my problem is VOLUME, and the band will help with that too..... I am the first person in my Real Life that will have a band. I do have 2 friends that went the bypass route (now 2 and 4 years) post op.. I always knew that surgery wasn't for me.......... Lemme see.... I am 37, divorced in 2002 but with a great guy now going on 2 years... we share a life and kids but not married.. I have a son who is now 3 and the light of my life.. although he is often to smart for his own britches... I think my light bulb moment was at his skating party I could not get up off the floor of the rink without help (I was in skates, and on one knee to tie his laces) I was humiliated and p.o.'d!!!!!!! I want to be the active mom not the "let mommy rest" mom.... so here I am with baited breath (as you said it perfectly) waiting for a surgery date, so that the rest of my life can begin!

Hey y'all! So I'm scheduled for vsg March 14th and went in for blood work on Monday to make sure all my levels were ok. The results came back saying my cholesterol was a little bit high and my thyroid levels were low. The nurse then called me back to say the Dr told her to tell me that I may have hyperthyroidism... which is od because I thought low levels meant your thyroid was under active and hyper meant it was over active, yes? I'm assuming she just got it backwards and meant to say I may have hypothyroidism. ANYWAY! The Doctor wants me to come back in 6 weeks for more blood work... why he wants to wait 6 weeks is beyond me, I guess to see if the levels change and maybe it was just a one time thing? I don't know. Either way, for those who have either hypo or hyperthyroidism... how has it affected [effected? lol] your journey? Did you find you lost slower than others? Thanks in advance! TLDR: How has hyper or hypothyroidism impacted your vsg journey?

Second guessing and some regret is normal when one runs into problems. It is well to realize that whatever road you chose in the past was likely to be bumpy, even if the bumps might have been different. The bypass, in addition to having its own quirks (someone just showed up on today's recent topics column who is having reactive hypoglycemia problems - that's one of those quirks,) that can cause regrets, would not likely have been any better on helping you with your regain (RNY and VSG are very similar in that regard,) and is also more difficult to revise should you have had problems. So, there is (and was) no easy, straight answer. We follow what looks like the best road for us and take what life throws at us over time..

Food and liquid timing, pyloric sphincter function, and how it pertains to VSG function and GERD: The pyloric sphincter (PS) is located at the bottom of your stomach/sleeve, and connects the sleeve and duodenum. When open, this valve is roughly the diameter of a dime. When closed, it’s roughly the diameter of the tip of a ballpoint pen. In terms of VSG function, dense proteins and foods that take longer to digest (i.e. fibrous foods) cause the PS to close and hold food in the stomach for pre-digestion, allowing acids begin to break down these foods. This is why we’re instructed to eat protein first: to close the PS so that food stays in the sleeve longer, providing a sense of satiety. It takes ca. 30-60 minutes for food to clear the PS. This is also why we’re instructed not to drink liquids for 30-60 minutes after eating. Incidentally, "slider" foods do not close the PS: instead, these foods "slide" directly through the open PS into the duodenum. In terms of GERD, after you consume a protein-dense meal, the PS closes, holding the contents of the meal in the sleeve for pre-digestion. If you drink liquids within 30-60 minutes after a meal, the liquid has nowhere to go but up, where it hits the lower esophageal sphincter (LES), and above that, a flapper valve. The function of both of these valves is to prevent food, bile, and acids in the stomach from backing up into the esophagus. This is an exceptionally high pressure system, and is the reason why it hurts when you eat to much or too fast, or drink too soon, after eating when the PS is still closed. Vomiting and/or foamies is the only available pressure release. Even in a full-size stomach, the addition of liquids to food speeds gastric emptying by roughly 15%-20%, and some studies indicate that the transit time is anywhere between 25%-35% after VSG. *It’s also interesting to note that after VSG, simple carbs passing through the PS are less liquified due to fewer digestive enzymes being available than with a complete stomach, which is also what causes dumping and reactive hypoglycemia. These unhealthy simple sugars pass directly through the pylorus, causing pancreatic enzymes to flood the bowels in order to be able to digest them. The pancreas then reacts by “dumping” large amounts of insulin into the common bile duct, causing a massive reduction in sugar absorption and feelings of weakness and other diabetic symptoms. It’s very similar to dumping syndrome in RNY patients.

That is curious, and beyond my limited experience! I suppose that is can be strictly an esophageal problem, though as I noted, I have only seen such things as they related to other root causes. No, I haven't had such a revision, though it was suggested at one time for another issue, but I have avoided having to go that route (with the help of some second opinions that basically said to leave well enough alone for now.) I do have minor GERD, which is readily treated with low level OTC meds, so there is nothing worth fixing at this point on that account. The sleeve is predisposed to GERD by virtue that the stomach volume is reduced a lot more than its acid producing potential, but the body usually adapts to that over a few months, and most surgeons prescribe a PPI for the initial few months and then wean off of them. (Similarlly, the RNY is predisposed to dumping, reactive hypoglycemia and marginal ulcers, so there is no free lunch in that regard, no matter what procedure one goes with - there is always some risk there.) I would prefer to keep the sleeve as long as it cooperates, as the RNY is a little bit fussier to live with, but it's not the end of the world, either, and certainly preferable to what you are going through; my wife has a DS which is a bit fussier still, so I'm familiar with all that entails if I need to go there. The surgeon who has adopted our local support group does quite a few oddball and esoteric revisions (like the complex RNY to DS), people come from across the country to see him, and he sometimes pulls up scans on his laptop of one of the wonky sleeves that has come his way, so we get some feel of what can be done, that other surgeons pass on. That's why I brought up the stricture idea (beyond your regurgitation sounding like that might be it,) because that is something that many surgeons prefer to revise away rather than correct. I does seem like you are heavily restricted, much more so than normal for a normal sleeve, or RNY. 500 calories isn't so bad - it's not that unusual for people with any of these WLS to still be down there, though more commonly somewhat higher in the 6-800 calorie range; it's the water intake that I would be concerned with as dehydration will get one thrown into the hospital a lot faster than low protein or other nutrients in the short to intermediate term. The vast majority of people go through this, an RNY, or VSG, or a DS, with little or no complications, but sometimes they crop up; hopefully, you have had your share of them now and that's it. In some respects, the RNY is a more familiar procedure for the surgeons,, even if they don't do as many of them as sleeves, as it has been around in bariatrics for 40-50 years, so most started out with them; the basic procedure upon which it is based has been around for some 140 years in treating gastric cancer and other GI maladies, so it is familiar territory for most; the VSG on the other hand, had more limited application until it was created/adopted for WLS as part of the original BPD/DS, so it was not as widely used until the DS guys started using it some by itself (usually as part of a two stage DS) and saw that it offered good weight loss all on its own, so I wouldn't worry too much about your surgeon's experience with it, as that was the default WLS in Canada until fairly recently.

I have not been tested for reactive hypoglycemia. How do you test for that? Also, an interesting development...a family member I live with was just diagnosed with acute Epstein Barr (mono). I'm thinking reactive hypoglycemia and possibly mono might be what is going on.

I am not a doctor nor do I have medical experience. So take what I say with a grain of salt. I am 3 years post-op RNY gastric bypass surgery. It seems like you have multiple conditions, so let me talk about these individually. General 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 looks like you have lost the weight are in the Maintenance phase. So generally your meal volume allotment is now large enough that if you concentrated on eating high protein meals, you might not need to add protein supplements (protein shakes, protein bars). I found it difficult to transition to solid foods (such as steak and chicken) after surgery so I primarily relied on softer foods such as chili and Soups. I fortified these with extra protein. I have included the recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf But if you are having difficulty keeping food down, then you may have to go back to protein supplements just to ensure you get the proper amount of protein in daily. Ulcers 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. So the general advice from above if I am interpreting it properly is to eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed. Also avoid NSAIDs (such as Aspirin, 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] and but use proton pump inhibitors [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. After RNY gastric bypass surgery, my surgeon put me on Omeprazole [Prilosec] for a year to lessen the affects of surgery on my stomach. Passing Out The fact that you have passed out a few times might be due to a condition called Reactive Hypoglycemia. This is a low blood sugar condition that affects some RNY patients. Here is a link that describes the condition. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass

I was never a ketosis kid either. I was very intent on avoiding post-bariatric reactive hypoglycemia, so I always tried to eat at least as many carbs as Proteins (grams). I reached goal (150 pounds at 5'5" and 69 years old) at 8-1/2 months post-op. And now I'm 3 pounds below that while trying to stop losing. I'm averaging about 1400 calories/day the last few weeks. But still losing very slowly. I eat extremely healthy -- lots of good veggies and fruits, typically 100 grams of Protein daily, whole grains, very little refined sugar and other refined carbs. Always take my vits/mins, and my big four-page blood panel results found everything was normal and good. Feeling good. Looking good. All going good here. So here's my challenge of the moment: It's a challenge for me to mentally *agree* to stop losing. Seeing the scale go down, even 0.2 pounds, is definitely a more positive feeling than seeing it stand still. Honestly, I'm a little worried about that. The idea that I could become anorexic is ridiculous to me. But I do realize that I've got to change my attitude into one that feels rewarded by seeing my weight stabilize. Anybody got any thoughts on that front? BTW, many thanks to @@Rogofulm for lobbying Alex to open this maintenance forum. Thank you, Rog.

So you don't think I've got reactive hypoglycemia? Sorry a bit confused as I'm not oregnant I'm 48 and a year post op these symptoms only came on a few weeks ago and this is what another experienced sleever said I had and fits my symptoms. I will ask my GP for a blood monitor when I see her next week and as I'm in the uk I hope they supply it on the NHS even though I'm a self pay bariatric patient.