GREAT HELPFUL INFORMATION-PRINT!

Hello all, I just copied and printed all of this from the main message board. I didnt' want my board members (ha! board members) to miss out on this weath of information. It is A LOT! So, I would suggest just printing it as I did. Too much for me to sit here and read! UGH! Great info to have at hand though. Here it is..... Tracy Ewwww That Smell . . . Recently, during a showing of Oprah actually, an uprise in misinformation has been causing some confusion among those embarking on the journey of Weight Loss Surgery - this whole issue is pertaining to this supposed 'horrid', 'ghastly' "ODOR" that happens and mythically lingers and makes you stink for the rest of your life. Yeah, you heard me right, can we say MYTH? The 'odor' in question is a process the body goes through briefly as it adjusts to it's new 'fuel'. This process is called Ketosis. Oddly enough, with all the major eyebrows and questions being raised about this phantom stench that supposedly all weight loss patients experience everyone needs to just stop, and think about it for a moment. Ketosis occurs EVERYTIME you go on ANY diet that limits your carb intake, it happens if your diabetic or even pregnant. Now, be honest here, how many times have you walked into a room full of dieters and been knocked over by the stench? How many times have you walked into a doctor's office full of pregnant women or diabetics and been knocked over by how horribly they smell? Exactly. Ketosis is not that bad at all. WHAT IS KETOSIS? Ketones are chemicals that your body produces as a by-product of combusting fat and 'waste' products. Ketosis happens during fasting, while on low carbohydrate diets, pregnancy and it can be caused by diabetes. You use up your store of glycogen (blood sugar) and then your body permanently goes into fat burning mode to fuel your bodily functions. This change in metabolism occurs when the body no longer has incoming carbs to produce glycogen and after the liver has been depleted of stored glycogen. When either stored body fat or incoming dietary fat is used as fuel it breaks down into ketones. Ketones can be used as fuel for your body or discarded via your breath or urination sounds pleasant doesn't it? It is the rise in ketone production that means you are in ketosis. Take note that although you are in ketosis this does not mean that you are *only* burning bodyfat. The released ketones may be from either bodyfat or dietary fat. Why do we want to be in Ketsosis?: We want to be in a metabolic state where, without incoming carbs, and without consuming too many grams of dietary fat or protein, our bodies will be burning stored bodyfat as fuel. Positive side effects of being in ketosis are that it can be protein sparing (allowing us to retain lean body mass) and that it can lead to a decrease in appetite for some people. NOTE: Ketosis is NOT ketoacidosis. There are two types of ketoacidosis: diabetic ketoacidosis (which is due to simultaneous rise in blood glucose and blood acidity) and alcoholic ketoacidosis (which is due to heavy alcohol consumption without food intake). If you do not fall into either of these groups your body should have the feedback loops that will keep ketone production in check. Ketones are produced daily by most people to some degree and are a part of the body's system of survival. What are side effects of Ketosis? Bad breath - which is due to ketones being released through your breath, drinking more water will lessen this effect. Some people also report that they get a metal taste in their mouth. Strong urine odor - due to the presence of ketones. Light headedness or "foggy" thinking. This does not occur in everyone and many who do feel this often are helped by making sure they are getting enough to eat, enough water and taking potassium supplements. How long will it take me to reach ketosis? It is dependent upon a few factors. Since you start the production ketones after the liver has been depleted of stored glycogen, the amount of stored glycogen is the primary factor. How much glycogen your liver has stored depends on your very recent calorie intake and activity. If you have already been on a low calorie plan you may have a small amount stored. Depleting the amount of glycogen you do have is dependent upon how fast you body uses up that storage. Therefore you can hasten the depletion of you glycogen storage by being more active. The other factor in developing ketosis is the how much free fatty acids are available to burn. Ketosis is a temporary stage that WLS patients go through, because of our supplementation and protein requirements Ketosis won't last long, many don't even realize they've experienced it to begin with. Which is the issue, absorption or malabsorption? In the gastric bypass patient aren't they essentially one in the same? Absorption, whether it be food, supplements, medications etc., is now a very serious issue for you and it should not be taken lightly or for granted. Did you kow that your iron and calcium supplements need to be taken seperately and at seperate times in order for your body to absorb them properly? Did you know that taking something as simple as an aspirin could leave you with that lingering headache even hours later, all because you can''t absorb enough of it's medicinal properties before it's digested? Malabsorption comes with the new metabolism 'package', it's part of why the surgery works. The important issue at hand however is what is it that you are going to do with this knowlege? I'll give you a shining example of how serious the absorption, or rather malabsorption issue is with us. I live with a couple of chronic pain disorders, the likes of which can send me into severe spasms of pain. My primary care physicians will NOT even consider prescribing pain killers for me because of the gastric bypass procedure. They know I have major malabsorption problems because of the gastric bypass, and as such feel prescription pain killers would be not only a waste of time, but of money as well. My expressed directions in case of the pain flaring up so bad that I cannot stand it; go to the emergency room where they will administer muscle relaxants and pain killers via I.V. until I have relief. It's not just medicine that doesn't get absorbed properly, it pertains to everything, your food, your nutrients and supplements - you name it, you've got to deal with it. If you don't take this facet of the new physiology seriously you are the one who is going to suffer, and suffer you will. The name of the game is simple. No matter how you feel, good, bad, whatever . . . you MUST supplement and you MUST eat regularly (and properly!) in order to stay healthy. ANY deprivation your body is being put through or even thinks it's going through at your hand is going to cause problems. If your not feeding it every couple of hours, it's going to think it's not going to get fed - or that your going back to that 3 squares a day ritual and it's going to slow down on weight loss or halt it altogether. It does this as a survival tactic and it will store the stuff it has been fed for a rainy day. If you're not supplementing your body properly what do you think is going to happen? You're going to end up with a body screaming for attention and crying out for help! If it's not getting the proper nutrients, it is NOT going to operate properly. If it's not operating properly ultimately YOU PAY FOR IT! A lot of people look at me quizzically when I say, "If I can avoid it, I don't eat bread, pasta, lettuce or celery." The reason I avoid those things like the plague is that I have a 2 ounce stomach that I have to feed every two hours to maintain my health. My thinking in this is as such; bread and pasta are high in carbs AND they fill me up, leaving no room for foods with nutritional values that my body needs. Lettuce and celery on the other hand, have zero calories and very little nutritional value, wasting stomach space for foods that will do my body good. My primary goal is to get as much protein, fiber, and calcium rich foods into my system each day as possible. Couple this with my vitamin regime in the morning, my Niferex at eleven (by itself), and my vitamin regime again in the evening . . . and I'm getting in everything I need each day to maintain my health and wellness. In the event that I do get prescribed a medication that I must take orally, for example an oral antibiotic, I will take it with a bit of whole grain bread. I know that bread 'clumps' and will take a great deal longer for me to digest and as such if I take my oral medications with it I know my chances for maximum absorption of the drug are much greater. At the risk of sounding like a broken record, it all boils down to following the rules, following all the directions and listening to what your body is telling you. If you do this, you won't really have to worry about absorption or rather malabsorption issues. Calcium is a major mineral and a very necessary supplement in the weight loss surgery patients new diet.Calcium is a mineral that primarily functions in your body by making your bones and teeth hard. The rest is in your blood and soft tissues; it helps your muscles contract and your blood clot, and helps your nervous system work properly. A commonly overlooked facet of getting in your daily calcium requirement is that of the need for Vitamin D in order for your body to properly absorb and utilize the calcium properly. Without the one, the other is pretty much void. Major dietary sources of Calcium include milk and milk products, canned salmon and sardines (with bones), dark green leafy vegetables, calcium-precipitated tofu, legumes (dried beans) and cheese. The percentage of calcium absorption varies and is dependent on the needs of the body. Lactose (the sugar in milk) and protein aid in Calcium absorption. A commonly unknown fact to the WLS patient is that because of our lack of stomach acids, we are unable to break down, absorb and process, let alone digest Calcium Carbonate, so it is very important that you make sure that you are using Calcium CITRATE. How much calcium do you need? There is a conflict between the U.S. Recommended Dietary Allowance and what the dairy advocates would have you do; the latter bases its numbers on a National Institutes of Health symposium on calcium consumption. Milk - It Does A Body GOOD! RDA NIH "Optimal Calcium Intake" Adults 800 mg 1,000 mg Adults over 65 N/A 1,500 mg Pregnant and nursing women 1,200 mg 1,200 mg Young adults (11-24) N/A 1,200-1,500 mg Children under 11 800 mg 800-1,200 mg Is it possible to take too much calcium? According to the National Institutes of Health, yes. Although it should be safe for adults to consume up to 2,000 mg of calcium every day without adverse side effects, the institute says, going over that may lower the absorption of certain medications, such as tetracycline, and of some nutrients, including iron. Overuse of calcium carbonate (available commercially as the active ingredient in Tums and other antacids) can also lead to severe renal damage and other problems related to calcium toxicity. Calcium and kidney stones Some studies have indicated that men with a history of kidney stones may make the problem worse by increasing their intake of calcium. In other studies, men with low calcium intake suffered fewer kidney stones when they consumed more calcium. The NIH says more study on the calcium-kidney stone link is needed. Calcium and osteoporosis Getting enough calcium is one of the best ways to prevent osteoporosis, a debilitating disease in which the bones deteriorate and take a long time to heal. One-half to one-third of post menopausal women will get varying degrees of osteoporosis; of the 25 million Americans with osteoporosis, one in five is male. Major Body Functions: Builds and maintains strong bones and teeth Helps to regulate heartbeat and muscle contractions Is needed for proper blood clotting Aids in regulation of blood pressure and water balance in cells Deficiency Symptoms: Rickets (softening of bones) in infants and children Osteomalacia (softening of bones) in adults Osteoporosis (thinning bones) Possibly hypertension (high blood pressure) Excessive Intake and Toxicity Symptoms: Calcification of bones and soft tissues Kidney stones Rapid gastric emptying, or dumping syndrome, happens when the lower end of the small intestine (jejunum) fills too quickly with undigested food from the stomach. "Early" dumping begins during or right after a meal. Symptoms of early dumping include nausea, vomiting, bloating, diarrhea, and shortness of breath. "Late" dumping happens 1 to 3 hours after eating. Symptoms of late dumping include weakness, sweating, and dizziness. Many people have both types. Stomach surgery is the main cause of dumping syndrome because surgery may damage the system that controls digestion. Treatment includes changes in eating habits and medication. People who have dumping syndrome need to eat several small meals a day that are low in carbohydrates and should drink liquids between meals, not with them. It is imperative to the Roux En Y or other procedural gastric bypass patient that they follow their diet plan to reduce the risk factor of Dumping Syndrome. Many people equate the term solely to be spasmodic fits of diarrhea, when that is merely one of the symptoms of a more intensified unpleasant experience. Dumping syndrome is usually divided into "early" and "late" phases - the two phases have separate physiologic causes and shall be described separately. In practical fact, a patient usually experiences a combination of these events and there is no clear-cut division between them. Early dumping is caused by the high osmolarity of simple carbohydrates in the bowel. The various types of sugar all have small molecules, so that a gram of (for example) sucrose has MANY more molecules than a gram of protein, creating a higher concentration (number of molecules per cc) from simple sugars than from other foods. This matters because, inside the body, fluid shifts will generally go toward the higher concentration of molecules. So, if a patient consumes a bite of milk chocolate (lots of sugar), when it gets to the Roux limb it will quickly "suck" a significant amount of fluid into the bowel. This rapid filling of the small bowel causes it to be stretched (which causes cramping pain). This also causes the activation of hormonal and nerve responses that cause the heart to race (palpitations) and cause the individual to become clammy and sweaty. Vomiting or diarrhea may follow as the intestine tries to quickly rid itself of this "irritant." Late dumping has to do with the blood sugar level. The small bowel is very effective in absorbing sugar, so that the rapid absorption of a relatively small amount of sugar can cause the glucose level in the blood to "spike" upward. The pancreas responds to this glucose challenge by "cranking up" its output of insulin. Unfortunately, the sugar that started the whole cycle was such a small amount that it does not sustain the increase in blood glucose, which tends to fall back down at about the time the insulin surge really gets going. These factors combine to produce hypoglycemia (low blood sugar), which causes the individual to feel weak, sleepy, and profoundly fatigued. Late dumping is the mechanism by which sugar intake can create low blood sugar, and it is also a way for gastric bypass patients to get into a vicious cycle of eating. If the patient takes in sugar or a food that is closely related to sugar (simple carbohydrates like rice, pasta, potatoes) they will experience some degree of hypoglycemia in the hour or two after eating. The hypoglycemia stimulates appetite, and it's easy to see where that is going.... The reason that sugar does not cause dumping in non-operated people is that the stomach, pancreas, and liver work together to prepare nutrients (or sugar) before they reach the small intestine for absorption. The stomach serves as a reservoir that releases food downstream only at a controlled rate, avoiding sudden large influxes of sugar that can occur after a Roux En Y. The released food is also mixed with stomach acid, bile, and pancreatic juice to control the chemical makeup of the stuff that goes downstream and avoid all the effects outlined above. Obviously, surgeons consider dumping syndrome to be a beneficial effect of gastric bypass - it seems to be important to provide quick and reliable negative feedback for intake of the "wrong" foods. In practice, most patients do NOT experience full-blown dumping more than once or twice. Most simply say that they have "lost their taste" for sweets. Of course, this is always a great topic to ask patients about directly, so you may want to ask about it at our support group in person, or in a support group online. It is an unpleasant side effect of this surgical procedure, experiencing it means one simple thing; you are not following your prescribed diet, and unless you do, dumping syndrome is going to become a major part of your life. Do yourself, and your body a favor and follow doctors orders, to the letter. Purpose Dietary fiber is the part of a plant that provides and maintains the plant's structure. Cellulose, hemi cellulose, polysaccharides, pectin's, gums, mucilage's, and lignin's are dietary fibers. These fibers are unrelated chemically, however, they all have one thing in common -- the human body can't digest them. For this reason, they can help correct disorders of the large intestine (colon), and keep it functioning normally. Therefore, it is important to increase the amount of fiber in the diet. Function of The Colon The main job of the colon is to complete the digestion process. This occurs by removing excess water from food wastes entering from the small intestine. When wastes pass through the intestines too quickly, not enough water is absorbed. Watery stools and diarrhea are the result. In contrast, if the passage of waste is too slow, too much water is absorbed. This results in hard stools and constipation, which often leads to straining. These simple problems occasionally lead to more serious disorders. The Importance of Dietary Fiber Fiber (also called roughage or bulk) promotes the wavelike contractions that keep food moving through the intestine. Also, high-fiber foods expand the inside walls of the colon. This eases the passage of waste. Fibrous substances pass through the intestine undigested. They also absorb many times their weight in water, resulting in softer, bulkier stools. Studies show that rural Africans, who eat diets high in fiber, eliminate food waste in one-third the time it takes people from urban westernized cultures. Their stools are larger and softer. Because of the greater bulk and speed of foods through the digestive tract, it is believed that harmful substances are also swept out before they can cause problems. In fact, these rural people have fewer of the digestive tract diseases that plague Western man. It is thought that this may be related to the nature of their diet. A high-fiber diet causes a large, soft, bulky stool that passes through the bowel easily and quickly. Because of this action, some digestive tract disorders may be avoided, halted, or even reversed simply by following a high-fiber diet. A softer, larger stool helps prevent constipation and straining. This can help avoid or relieve hemorrhoids. More bulk means less pressure in the colon, which is important in the treatment of irritable bowel syndrome and diverticulosis (defects in the weakened walls of the colon). In addition, fiber appears to be important in treating diabetes, elevated cholesterol, colon polyps, and cancer of the colon. Nutrition Facts As long as a balanced selection of foods from each of the basic food groups is chosen, the High Fiber Diet is nutritionally adequate. Some studies indicate that excessive intake of certain dietary fiber sources may bind and interfere with the absorption of the following minerals: calcium, copper, iron, magnesium, selenium, and zinc. However, there appears to be no problem for those adults who follow a balanced, regular diet. Occasionally, a physician may prescribe supplements. The Use of Fiber in the Irritable Bowel Irritable bowel syndrome (IBS) is one of the most common disorders of the lower digestive tract. There is no disease present with IBS, but it creates bothersome symptoms such as altered bowel habits -- constipation, diarrhea, or both alternately. There may also be bloating, abdominal pain, cramping, and spasm. An attack of IBS can be triggered by emotional tension and anxiety, poor dietary habits, and certain medications. Increased amounts of fiber in the diet can help relieve the symptoms of irritable bowel syndrome by producing soft, bulky stools. This helps to normalize the time it takes for the stool to pass through the colon. Liquids help to soften the stool. Irritable bowel syndrome, if left untreated, may lead to diverticulosis of the colon. Fiber and Colon Polyps/Cancer Colon cancer is a major health problem. This disease is most common in Western cultures. Most colon cancer starts out as a colon polyp, a benign mushroom-shaped growth. In time it grows, and in some people it becomes cancerous. Colon cancer is usually always curable, if polyps are removed when found or if surgery is performed at an early stage. It is now known that people can inherit the risk of developing colon cancer, but diet may be important, too. There is a very low rate of colon cancer in residents of countries where grains are unprocessed and retain their fiber. The theory is that in the Western world, cancer-containing agents (carcinogens) remain in contact with the colon wall for a longer time and in higher concentrations. So, a large bulky stool may act to dilute these carcinogens by moving them through the bowel more quickly. Less carcinogenic exposure to the colon may mean fewer colon polyps and less cancer. Fiber and Diverticulosis Prolonged, vigorous contraction of the colon, usually in the left lower side, may result in diverticulosis. This increases pressure causing small and eventually larger ballooning pockets to form. These pockets usually cause no problems. However, sometimes they can become infected (diverticulitis) or even break open (perforate) causing pockets of infection or inflammation of the sac lining the abdomen (peritonitis). A high-fiber diet may increase the bulk in the stool and thereby reduce the pressure within the colon. By so doing, the formation of pockets is reduced or possibly even stopped. Some professionals recommend restricting the following foods in diverticulosis diets: nuts, poppy seeds, caraway seeds, rye seeds, popcorn, crunchy peanut butter, corn, cucumber, and squash; as well as fruits and vegetables with seeds such as strawberries, figs, and tomatoes. However, there has never been any medical proof that these foods are injurious. Many gastroenterologists allow and even encourage consuming these foods, depending on an individual's tolerance. Fiber, Cholesterol and Gas Insoluble fiber is found in wheat, rye, bran, and other grains. It is also the fiber found in most vegetables. Insoluble fiber means it does not dissolve in water. Intestinal-colon bacteria also cannot use it as a food source, so these beneficial bacteria generally do not grow and produce intestinal gas. Soluble fiber, on the other hand, does dissolve in water forming a gelatinous substance in the bowel. Soluble fiber is found in oatmeal, oat bran, fruit, psyllium (Metamucil, Konsyl), barley, and legumes. Soluble fiber, among its other benefits, seems to bind up cholesterol allowing it to be eliminated with the stool. If enough is removed it can lower the blood cholesterol 10-15%. The down side of soluble fiber is that it can be metabolized by gas forming bacteria in the colon. These bacteria are harmless but for those who have an intestinal gas or flatus problem it is probably best to avoid or carefully test soluble fibers to see if they are contributing to intestinal gas. Whenever possible, both soluble and insoluble fiber should be eaten on a daily basis. A Dietary Fiber Supplement May Be Helpful Some people don't tolerate fibrous foods well. If you can't consume enough fiber in your diet alone, certain stool softening and bulking agents are available. These products absorb water and produce the bulk necessary for the digestive tract to perform naturally. They help create a soft and well-formed stool. For this reason, they can be very useful in preventing and treating digestive tract disorders. Metamucil, Konsyl, and Per Diem Fiber are such products. These contain psyllium mucilloid and come from the seed of the psyllium plant. Citrucel (hemi cellulose) and Fibercon (polycarboxisal) are other bulking agents that can also be used. Protein Original Post by Michelle Robinson at 9:32 PM PST on 03/17/2004 West Olive, MI - RNY (08/21/2000) How Much Protein Do You Need? Click Here to Find Out - http://www.healthscout.com/iwon.asp?page=protein&ap=52 Protein What is it? Proteins are the building blocks that grow and repair your body. Proteins are needed not only for muscle but also for hair, skin and internal organs. Some proteins travel around your body in the blood as hormones, enzymes and red blood cells. Protein is unique because it is the only food source of nitrogen, which is essential to all plant and animal life. Proteins are made up of chains of amino acids. For each protein, there are specific amino acids in a specific amount, and they are joined in a unique order. This is what makes a chicken different from cheese or a fingernail different from a strand of hair. There are 22 amino acids. Eight of these are called the essential amino acids because they cannot be made by the body and must be provided by the diet. What does it do? · Antibodies, which are made of protein, help you resist disease and infection. · Each day, your body loses protein in the form of hair, skin and nails. You also use up protein in all the activities of running and maintaining your body. · If you eat protein daily, it is supplied to your body tissue to replenish any loss and repair any injury. · For growing infants, children and teens, protein, along with sufficient calories, is necessary for growth of the entire body. · Pregnant and breast-feeding women need adequate protein for the fetus, for supporting maternal tissue, and for the production of breast milk after delivery. · If you have a cut, undergo surgery, or have an injury or illness, you need protein to recover and to rebuild your body. Where do you get it? Protein foods are classified in two ways: complete and incomplete. Complete proteins, which come from animal sources such as chicken, fish, dairy and soybeans, contain all the essential amino acids that help build your muscle and body tissue. Incomplete proteins, found in plant foods, such as grains, seeds, nuts, beans and vegetables, provide a varying but limited array of amino acids. A greater variety and amount of incomplete proteins must be consumed to cover all the amino acids needed for protein building. We can compensate for the amino acid deficiencies in an incomplete protein by combining it with another protein, thus providing all the building blocks for protein creation. This is the concept of complementary proteins, in which proteins with opposite strengths and weaknesses complement each other. For example, many cereals are low in an amino acid called lysine, but high in methionine and cystine. Lima beans, soybeans and kidney beans are high in lysine but low in methionine and cystine. Many cultures, including Mexican and Indian cultures, have limited animal protein sources but eat combinations of incomplete foods. Examples of appropriate combinations include: · rice and beans · cereal and milk · beans and corn · bread and cheese Recent research indicates that such combinations need not be eaten at the same meal. If they are consumed over the period of a day, the necessary building of muscle and body tissue will occur. Vegetarians thrive on non-animal protein diets because of our body's ability to do this. Use the following chart to help select foods that are good sources of protein. Food Grams of Protein 6 oz. canned tuna 40 4 oz. chicken breast 35 3 oz. beef* 26 3 oz. turkey 25 3 oz. salmon 23 8 oz. (1 cup) garbanzo beans 15 8 oz. (1 cup) milk 8 8 oz. (1 cup) yogurt 10 4 oz. (1/2 cup) tofu 10 4 oz. (1/2 cup) cottage cheese 14 1 egg 6 1 oz. cheddar cheese 87 8 oz.(1 cup) pasta 5 *A 3 ounce serving of beef (or chicken) is about the size of a deck of cards. How to increase your protein intake Here are five ways to increase protein in your diet if you need more than you are currently getting. 1. Increase your meat serving at lunch or dinner by just one ounce to add seven more grams to your daily protein intake. 2. Make a high-protein breakfast drink by blending a cup of yogurt or silken tofu, a cup of milk and your favorite fruit. Bananas and strawberries work well. You may want to add ice. 3. Add shredded cheese, cottage cheese or garbanzo beans to a tossed salad at dinner. 4. Add a little protein to your snacks. Put peanut butter on apples, drink milk with cookies, or use cheese cubes to make a kabob with grapes, pineapple and cherries. 5. Mix protein into foods. For example, you can make an eggnog of egg substitutes, milk and sweetener, stir nonfat dried powdered milk powder into hot cereal or mashed potatoes, or add powdered egg whites to applesauce. RE: Protein Response from Margaret Stanley at 9:35 PM PST on 03/17/2004 LaGrange, GA - RNY (03/10/2004) I just read the label on a can of tuna and it only says 13grams of protein. Is the albacore tuna 40grams? The Plateau Original Post by Michelle Robinson at 9:33 PM PST on 03/17/2004 West Olive, MI - RNY (08/21/2000) THE PLATEAU It happens to even the most dedicated and careful of us. Some see it as a reason to give up hope. Just see it as a signal from your body that it's time to make some more changes. It happens to the best of us, it's called a plateau. Don' think of it in a definitive sense, think of it as a new direction or path that needs to be followed. For many of us, we forget that our bodies will eventually adapt to the changes it's being put through. When you roll over another three thousand miles on your cars odometer, don't you give it an oil change? Same thing holds true with weight loss surgery, every now and then you need a change. Jump Starting Your Weight Loss: ROUX EN Y PROXIMAL PLATEAU - AVOIDING & BEATING ONE How Do I Get Back On Track? Ask Yourself the Following Questions: » Am I eating 6 small meals a day, and including protein in each one? » Am I drinking 64 ounces of (preferably) H20 a day? »drink 64 oz. of water a day »never drink carbonated beverages »caffiene is an appetite stimulant »If I am eating between meals, is it a protein snack? »Am I using condiments with my meals such as sour cream, mayo, butter or other high fat additions? If so, use the 'un'leaded versions. »Am I eating foods high in starches/carbs such as bread, pasta, rice, crackers, tortillas, chips or potatoes? If you are . . . STOP IT, and the plateau is history. »Am I eating any fruit? (You should be occasionally) »Am I getting regular exercise? Sustained 40 minutes of aerobic activity; walking, biking, hiking, swimming, treadmill, healthrider, dancing or other physical activity. » Go back and start your diet over again. Rethink your food choices and figure out if something you've been eating lately would give your body cause to plateau. » Are you eating every two hours? Remember, six to eight SMALL meals is the goal here, not fewer, larger meals. » Are you getting in all your nutrients and supplements? » Have you recently decreased your exercise - you ARE exercising right? » Have you exercised yourself into a 'stalemate' sort of situation? As you begin to get into shape, it will take more intense exercise to keep your body reacting to your new lifestyle . . . your body will build a tolerance to it. Next time you're working out ask yourself; Am I spending enough time on this? Am I breaking a good healthy sweat? Is what I am doing cardiovascular/aerobic enough to increase my heart rate? Is there something more I could be doing? » Go to a support group meeting, find out if others have had similar situations and what they've done to successfully overcome a plateau. HELPFUL HINTS - - Get some Support! - Seek activities that 'perk' you up and you enjoy - Start exercising an hour a day - Go back to the basics = 70% Protein - 30% Veggies & ALL your supplements! - Find a 'balance' that fits 'you' and your personal needs - Increase your liquids to 64 oz a day, it really IS important - Visit your doctor - Cut out ALL sugar - fruits, fruit juices, cookies, candies, sweets (no cheating yourself!) - Cut out the Carbs - put yourself back into ketosis and 'jumpstart' your weight loss - Be HONEST with your appraisal of your health and your current condition, are you TRULY doing everything 'by the rules? Remember, don't think of a plateau as a bad thing, think of it as your body communicating with you - it's letting you know it's time for another change. Listen to it, and go on from there! THE TEN COMMANDMENTS OF WEIGHT LOSS SURGERY 1. Thou SHALT NOT drink with thy meals. This means never. This is cheating...cheating yourself. It washes the food out of your pouch and allows you to eat more. This will slow and eventually stop your weight loss. 2. Thou SHALT eat slowly, very slowly. This rule is for the rest of your life. Eat too quickly and you will learn the hard way...the nausea is stifling. 3. Thou SHALT take thy vitamins. This surgery is a great tool for weight loss. But, as with all benefits, there are costs...and malnutrition is one of the costs of this surgery. Take a multivitamin supplement every day for the rest of your life. 4. Thou SHALT eat adequate protein. (72+ grams daily) 5. Thou SHALT exercise. Just do it. 6. Thou SHALT drink 64 ounces of water, everyday. It seems some people have problems doing this. Use a water bottle and carry it with you everywhere. Sip all day long. 7. Thou SHALT eat well-balanced meals. This means protein first and foremost, then green/yellow vegetables, then fruit, followed by starches. 8. Thou SHALT NOT eat sugar in any form - period. 9. Thou SHALT NOT modify these commandments to suit thy needs. It will not work. You will only defeat yourself, so go to regular support group meetings to remain motivated and on the right track. 10. Thou SHALT love thyself and be happy with the body God gave thee. Happiness comes from within. Be happy with who and what you are. ODORIFEROUS EMINATIONS - AKA GAS FROM HELL It's the disgusting, embarassing 'thing' that happens to even the best of us - even when we least expect it. For some it's worse than others, one thing for sure is that there has to be a way around it. What is it? Pure and simple, the whole issue of gas after gastric bypass. Immediately following your surgery, due to the nature of the beast, your abdominal cavity is going to be painfully full of air aka gas. In most cases this has subsided before you even leave the hospital. This isn't the gas issue at hand. Down the road however, it can and will become an issue again. The most common causes and 'cures' if you will that our members have found are the following: »Use Beano »Find out if you're now lactose intolerant, remove all dairy from your diet and see if you find relief. »Are you getting in enough fiber? Try supplementing with Metamucil in the mornings and see if you're able to get relief from the gas and discomfort. »Are you eating often enough? Oddly, a lot of patients get gasy when their running on an empty pouch. Some of us (myself included) will break into fits of hiccups if I need to eat. »Are you drinking enough water? »What did you eat prior to the gas attack? Try removing that from your diet. »Did you eat too fast, or 'gulp' even one bite? Believe it or not, your body will 'talk to you' and tell you if you're doing something it does not appreciate or if you're in need of feeding it again . . . as time passes you'll recognize the actions of the new physiology for what they are and be able to act accordingly. In the meantime, ask questions; chances are somebody else has experienced whatever your dealing with and can help you with a solution. The Surgery Survival Guide Coming Home From the Hospital Okay, let's face it. You've come down to the wire on a journey that all in all has taken you anywhere from 6-8 months to achieve that final goal::::drum roll please:::: your actual surgery date. You've run the gambit and proved yourself worthy of this new lifestyle in the past several months. You've joined Circle of Friends (and hopefully you're sticking to it rather than just dropping in for that one 'required' visit) you've had that psychological evaluation that made you second guess your sanity until the shrinks report found it's way to your mailbox and assured you that you weren't a certifiable freak of nature, you've endured all the presurgical testing and the oh so pleasant endoscopy where Dr. Don introduces himself to your stomach for the first time; now boys and girls it's time for the FUN part . . . taking care of making sure you're prepared for the recovery time following surgery! The best place to start is from the beginning. Get out your trusty handy dandy notepad and make a list, a thorough one of everything you are going to need immediately following your surgery. Keep that notepad handy as you may have a few fuzzy days when you first get home and it never hurts to take notes and cross reference your 'to do list'. Talk to our Roux En Y patients at the Circle of Friends Support Group Meetings; find out what they did, or their tips and tricks to making recovery more pleasant. The recovery is different for everyone, no two people are alike. Each of us have had a totally unique and diversified experience with our journeys and we rely on each other to keep us motivated, educated, inspired, and successful with our new lifestyles. You CAN do this and do it well. The biggest hurdle is believing in yourself. This surgery works, but only if you allow it too. It is a tool, not a cure, it is an aide, not an answer; Dr. Scholten operated on your stomach, not your mind. Within your mind you and you alone possess the drive and need to succeed. There are literally hundreds of us on the 'otherside' waiting for you to join our ranks; our elite club of success stories, to help us help others on their journey to long life and good health. THE LIST Your bag for the hospital - don't forget to pack your abdominal binder! Bring your favorite 'huggy' pillow to the hospital with you; abdominal surgery is a major trauma to your body and hugging your pillow while doing breathing exercises or to cough, sneeze or laugh is very helpful! Arrange for a babysitter for 'you' to help out when you come home Fill your prescriptions PRIOR to going to the hospital Your Supplements Baby spoons and forks (a baby food warmer is a really nice thing to have as well) I did a great deal of shopping in the baby food aisle before my surgery. I purchased baby sized bowls with lids, by First Years that are like Tupperware for infants, these work great for preparing a days meals ahead of time and are microwave and dishwasher safe. Your grocery shopping done prior to going to the hospital - at our house my family has designated that pain in the butt skinny good for nothing shelf in the fridge as "mom's shelf" that is where all my perishable foods are stored and everyone knows 'hands off' that shelf Make sure you have your surgery handbook with your postoperative care, diet and contact phone numbers handy Look into that NuSkin product and/or Vitamin E oil to help tend to your scar, you're going to want to show off that new waistline in a few months and you don't want to have a nasty looking scar, take care of your skin! Speaking of skin - your new diet is basically fat free, that means your body is not getting all the fat it once had to help keep your skin looking soft and supple. If you don't already have a favorite moisturizing product, you're going to need one. You are going to need plenty of Carnation Instant Breakfast, or whatever high protein supplementation that you are going to use on hand. The hospital sent me home with a couple dozen little one-ounce medicine cups; these have really come in handy especially during the first few weeks following surgery. If you can get your hands on some of them you'll be good to go! Quiet 'busy' works to occupy your hands and time while you're recuperating, needlepoint, and crochet, crossword puzzles, TV remote, whatever you need to pass the time. Find a walking buddy. My kids have added "walk the mommy" to their daily chore list. You shouldn't walk alone until Dr. Don releases you to do so, but it is very important that you get up and walk even if it's just out to your mailbox or out to the end of your driveway a couple of times a day. By this time you should've established a viable exercise program for yourself prior to your surgery, you are going to have to work your way back into mobility and exercise mode. Take it all ONE DAY AT A TIME. Your postoperative diet specifies eating every one and a half to two hours. There is a reason for this. Yes, you are going to go through a phase where you feel like you are pigging out and eating constantly, this too will pass my friend. Your body needs fuel, and your metabolism has now been seriously altered. The more pit stops you give it to refuel, the less inclined your body is going to be to say "excuse me, you're holding out on me and I don't know when I'm going to get fed again, so pardon me while I add this fat to your butt and thighs to save for a rainy day of fuel" You have to feed your body to lose weight, it's that simple. Keep a list of questions; problems, and concerns that you experience to take with you to your check up with Dr. Scholten, he and Mary Kay will take care of addressing those problems for you. This is a new experience, and they do understand. Be prepared to answer Mary Kay's questions, if you have a problem with the recovery you WILL be asked, "What are you eating?" If you're not following the prescribed process to a "T" they'll know about it! (And so will you!) Do NOT think that you're getting enough protein in because your hair isn't falling out the first 6-8 weeks following the surgery. In most cases hair loss starts occurring in the third month. It is caused by a combination of protein deficiency as well as being under the anesthetic for so long during surgery. Don't take it for granted and assume that you're one of the lucky ones. Get your protein in. I found out the hard way and am now minus years and years of healthy long locks of blonde hair, learn from my mistake and find out early what your daily requirements for protein intake is. Mine is 97 grams per day, it varies from person to person. Plateau's happen. Accept this fact. You may lose oodles of weight one month and nothing the next. On your plateau's review what it is that you're doing differently. Take a few steps backward in the program, start the diet program over again. Increase your exercise, what are you eating? What are you doing exercise wise? Would going to a support group meeting remotivate you to achieve your goal weight? How have others in your shoes dealt with plateau's? You, and only you are in control of your life, your body, mind, and soul. The decision you have made is one that is permanent. This surgery is nothing to be scoffed at or taken lightly. It IS a major surgical procedure and you will take a one year period of time to fully recover from the procedure and adjust to your new lifestyle. This is NOT a diet plan or some Johnny go lightly fad, it is a permanent change that will not only dictate your dietary needs, but your lifestyle needs as well. This entire process is all encompassing and you will be living, yes LIVING an entire new lifestyle. As the weight starts melting off of your body your energy levels will increase significantly. This will prompt you to 'overdo' it. Do NOT overdo it, follow Dr. Scholten's instructions to the letter! I'm Dr. Scholten's poster child for what not to do, if he told me one thing I was doing another, I smoked all the way to the hospital door and ended up in ICU with pneumonia, fully intubated with feeding tubes in my neck(I literally damn near died over a cigarette - imagine going through the surgery only to screw it up!?), I lived through that to turn around and refuse to wear my abdominal binder (I hated that contraption!) I thought I was superhuman/wonderwoman and I had all this massive energy; so what did I do? Promptly went out in September (yeah, a month postop) and tried to mow my lawn. I pulled all those raw sore muscles in my stomach and was damn lucky I didn't end up with a hernia. I have an allergy to adhesives, so I promptly 'itched' my steristrips off of my incision, I now have a scar that looks like a big red exclamation point on my stomach. Follow Dr. Scholten's guidelines. READ the contract he had you sign. Listen to your body, it will tell you when you're doing something right, and when you're doing something wrong. Don't be afraid to ask questions. You and your body will thank you in the long run. Here's to your health! One of the more often forgotten, overlooked issues regarding weight loss surgery patients is that this new physiology brings up a very serious issue in the event of an emergency. Sure, on any given day you could inform medical personnel that you're a gastric bypass patient. Sadly though emergencys do happen, and you never know when you will be in a situation where you are not able to alert medical staff that you have a problem. That problem is that in the event that you need to have any sort of evasive procedure to your gastrointestinal system; medical personnel MUST be aware that any sort of NG tube etc., has to be scope assisted so as not to injure your altered physiology. It doesn't matter if your surgery was laproscopic, distal, proximal . . . whatever, the need for your medical teams to be aware is mandatory for your health and well being. Medic Alert Alternative Medic Alert Jewelry is available all over the internet, you don't have to settle with the traditional I.D.'s, do a search and shop around for something you can live with if necessary. Just make sure that you get one!