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Today was my first day back to work. I weighed in on the Dr scale in the nurses office. 255lbs. Everyone said they could tell.

August 25

I was in room 5306-D. The room was tiny.  My roommate had to stay an extra day. The charge nurse Tasha was great! I had all good nurses but one, who didn't come see me for about 3 hours straight, 2nd shift.

I wasn't able to do the protein shakes when I got home. I threw up 4 times on Thursday. I could eat popsicles, jello, broth and juice only.

I had an extra hole. When I woke up from surgery I was on my back and was having trouble staying there. Once they gave me a pillow to be on my side I was fine.

That night I walked the hall one time and then slept in the chair. I got my catheter out the following morning and then walked the halls about 10 times during the day. I was taken off of the IV medicine and was given a loratab elixer, didn't taste very well. Was ok with my water trial.

That night one of my incisions started bleeding, so they glued that together.

I went home the following day, on Wed after having surgery on Monday.

Sept 9, 2008

I fell in the Walmart parking lot. I sprained my ankle and had to go to the hospital. I told the hospital about my surgery, told the triage nurse, my nurse and the Dr, I explained I needed liquid medicine. Then when the nurse brought me the medicine she brought me straight loratab pills. Oh well, about a half hour later I was able to leave. 4 x-rays, I'm ok.

Sept 12, 2008

I will never reccommend the CNY bariatric center!! I had an appointment to see Dr. Kim at 10 am, I didn't get brought back until 11:10. I explained I had a Dr. appointment for my ankle at 11:30 in Manlius. They didn't care! The women who took my weight, blood pressure and then threw me in another room to wait. She said there is always over an hour wait! That they service over 30 patients a day! Dr. Kim was nice, he gave me medicine for my thrush, looked at my rash, (my regular Dr, said it was hormonal since I had my period, she gave me a cream). He asked me if I was the G2 diet, and I said yes. He then said he wanted to see me in 2 weeks and to ask for the first appointment so I could get in and out.
I was unable to see the nutrionist b/c it was so busy. I wasn't even able to see her if I waited. I was told she was going to contact me. It is now the 21st, 9 days later, NO CALL!
I asked for an early appointment and was told I couldn't have one. I told the receptionist I needed to come back in 2 weeks. I was telling her I couldn't wait around for over an hour. She got mad at me and my fiance and yelled saying, There is an office manager, and she is not going to listen to my comments! I then yelled right back, saying it was ridiculus I had to miss my appointment with my DR b/c I had to wait so long and to give me an appointment so I could leave. My 2 week later appointment, is for 10/23 6 weeks later!!
My fiance is changing facilities. The office is a joke. I have never been treated so badly at a Dr's office in my life, and I am going to write a letter to the hospital.

9/21
I have been eating some variety of food. I have put myself on the third diet without any help of the nutrionist and hopefully am doing things correctly. I have lost 26 lbs since the surgery.

I have had a bad week. Starting with Friday the brakes, Saturday night geting sick, Sunday sleeping all day...

Monday at work:

I was scheduled to work 7am-7pm. We were piloting a new flex time, condensed work week.  I had approval by the person running the pilot in my group to work M-W 7-7 and TH 7-12:30. Around 3pm, the troublemaker in my unit, complains to my manager about my hours. My manager, rushes over to my cubicle, and yells at me about my hours, while I'm at my cubicle, everyone else is at their cubicle (my unit, and I sit next to another unit). He yelled that 7-7 was not acceptable, we were told we couldn't do that. I explained, I was never told. He then was, "What you weren't at the meeting?" I advised I was there, at both meetings, and that I didn't keep it a secret my intentions. I advised him, I had an email, from the Key Contact approving my schedule. He yelled, that he found it hard to believe, we weren't told. (Cuz I would make it up, and the fact I had an email, just plain lying to his face.) I again asked him, if he would like the email, and he said yes, he stopped coming at me like a bull, and huffed away.

I got an email back saying, b/c of the special circumstances of this week, and he is empathetic, that I can keep the hours.

This broke me, I was so upset. I cried at work. Then when I went home, I couldn't calm down and sleep. I went to bed at 9 and didn't fall asleep till after 1:30 AM.

The next morning, as soon as I got to my desk I started crying. I couldn't control my emotions. I went up to see the nurse, and I couldn't talk for awhile. I just bawled. I finally gained enough composure and she sent me home for the day.

I had to go back to work today to finish items, which had to be done before I went out.  I had a Dr appt at 11:3, I made one yesterday. The Dr. pulled me out of work until after my surgery, and gave me Zanex, to help me sleep, since I wasn't able to last night either.

Uugh!

I have to stop eating and drinking at midnight next Sunday. I cannot have water, gum or candy. My surgery is scheduled for 10am and have to be there at 8am. They will call me on Friday to let me know if this is the concrete time for my surgery. They finalize the OR schedule the previous business day around 2pm.

Post Operative Diet for Gastric Bypass

Summary of Diet Progression:

Stage 1: First 5-7 days: Clear calorie free liquids and protein shakes.
Stage 2: Until 4-6 weeks. Soft foods and protein shakes.
Stage 3: Long term: After 4-6 weeks. High protein, low calorie foods.

Fluid and Hydration:

One discharged from the hospital, yhou should be able to drink 3 oz of fluid per hour working your way up to 6-8 oz per hour.

Your goal for fluid should be at least 64 oz per day to prevent dehydration and constipation.

Sip Fluids continuously throughout the day.
Do not Gulp of Use a Straw. Do not Chew Gum. Doing so well will cause discomfort, bloating, and gas.

Stage 1 Diet: Clear, Calorie Free Liquids & Protein Shakes

Choose From:

Water
Herbal Tea
Decaffeinated coffee
Broth fat free or low fat
Crystal Lite
Diet gelatin
Diet Snapple
Diet Twister
Diluted fruit juice no more than 4 oz per day
Sugar free popsickles
Fruit20
Ocrean Spray Lite Juice
Skim Milk
Sugar free kool aid
Sugar free Popsickles

Avoid:

Sugar as a sweetener
Carbonated drinks
Smoothies
Kool-aid
Alcohol
Excessive caffeine
Milkshakes

Begin Taking a Protein Shake as soon as you get home from the hospital.

You have just had a major surgery. In the first 6-8 weeks, the goal is for your body to heal. Protein is important for healing, If you do not eat enough protein, your body begins to break down muscle in order to heal from surgery. This can lead to slow metabolism, poor weight loss results, haid loss, and skin breakdown. Therefore, you will need to drink liquid protein shakes. You need to drunk a protein supplement or shake in order to meet your protein needs for the first 6-8 weeks following surgery. The goal is to get at least 50-60 grams of protein per day. That is about 12-24 oz of shake perday. The dietitian will calculate your individual protein needs.

Tips when choosing Protein Shakes:

Protein should be the first ingredient. Example: Whey protein or Soy protein isolate.
Less than 150-190 calories per serving.
Less than 5 grams of sugar per serving.
No added sugar or oil in the ingredients list.
Do not use meal replacement drinks, such as Boost Ensure of Slim Fast.
These have added fat and sugar in addition to protein, and have too many calories. They may make you sick, and will prevent weight loss.

Commonly used Protein Shakes:
Carb Conscious or No Sugar Added Carnation Instant Breakfast.
12 grams protein/8 oz when mixed with skim milk.
Tip: Add 1/4 cup of fat free powdered milk to the mix to increase the protein to 20 grams.

EAS Advant Edge: REady to drink 11 oz cans have 15 grams protein in 11 oz

Designer Whey: Powder mixed with water or skim milk equals 18 gram protein when mixed with 8 oz water, 26 gram proetin when mixed with 8 oz milk.

Isopure powder: Powder mixed with water or skim milk.
25 gram protein when muxed with 8 oz water, 33 gram protein when mixed with 8 oz milk

Skim Plus Milk:
Can be purchased alread made of homemade and has 27 gram protein per 8 oz. Recipe: Mix 8 oz skim milk with 1/4 cup fat-free powdered milk.

If cannot tolerate diary, you could try milk alternatives such as Lactiad or soy milk. 

I will add the other stages later.

On Friday, the brakes went on the truck, when I was driving home. I had my fiance pick up the vehicle at the thruway so he could drive it. Well, the vehicle he was driving had brakes when he got out. When, I got in however, the pedal went to the floor. So both of our vehicles, lost brakes within an hour of each other, both when I was driving!!


The weekend sucked for me. I was fine till about 8pm on Saturday. I started getting cramping, and gas. I then got diarrhea for the rest of the night. It was just like green soup. After researching on the internet, I found out bile in its original form is green. Stool will be green, if the bile goes through the intestines to quickly.

I almost had a fever last night. I finally took ibuprofen, I am trying to stay away from it. b/c we aren't supposed to have it before the surgery, but I am still far enough away.

Today I have had a myrid of symptoms. I have had diarrhea, I have slept a ton, my back has hurt. I just want it to be over. I have to work 7-7 tomorrow. And I dont want anything to push off my surgery.

I had my appointment at 2 yesterday. I went in and got weighed by Marcy, she filled out all of the paperwork and gave me a copy of my chart.  I had lost 9lbs, but I did not make the mark I was told I had to make, I was 3 lbs away. Nothing was said to me about it. I don't believe my insurance company actually requires a loss. They required a 6/m program, but nothing concrete about numbers.  Also, nothing was said about support meetings. I had never turned in my card, b/c I started going before the cards were in existence. (Again, my ins co does not require the support meetings.)

While waiting for her, I saw the Sarah from the anesthesiologist. She had gone on a walk from the hospital. She explained to me what was going to happen, and about recovery. She told me I would see the Dr. right before surgery, and to write down any questions over the next week to ask him.

I have only seen the Dr. one time through my own process. I saw him the day I started the process in Dec. He spoke at the seminar and then in my breif meeting with him that day.  This is definatly not the program for someone who wants a lot of individaul attention.

I recieved the diet for after surgery. I will post it later. There was one for the first week, Weeks 2-6 and then forever.

At the hospital, I went to the central registration. I was taken to a cubicle, where they asked questions about my address, place of business, faith, etc. I was given the Patient Handbook. I was also given more parts of my chart. Including the hard plastic id, which has my name, address and patrient number on it.

Then I went up to the 2nd floor. I gave my whole chart to the nurse. I now have a binder with all of my information there. After waiting a little bit, I was weighed again, but in Kilos (127). There after waiting, the nurse brought in a computer. She asked health questions, asked if there was any chance I was pregnant. (I had started my mentral cycle on 8/13.) I advised her no. She asked if I was in any pain, I said yes, b/c of cramping, I was told I could have tylenol, but no ibuprophen b/c of blood thinning. 

She took 4 vials of blood. Marcy has them check out blood type and match it against a different chart in case we need blood during surgery.

Over all I got to the center at 2, and left the hospital at 5:30.

Through the whole process, no one ever brought up if I was supposed to go on birth control. I thought they automatically put me on it. They asked what pharmacy I used, but that was it. I don't know when I am supposed to start taking them.

the directions from Marcy on the diet said we would start taking flintstone vitamins and calcium after 2 weeks.

I finally did all of my measurements. Some of them I will not check all the time, but I wanted to know anyways.

Weight Around 289

Neck 15.25
L Arm 18.50
R Arm 17.5
Bust  55.00
Chest Band 47.50
Waist 51.5
Hips Flat 51
Whole Hips 57.5
R Theigh 31
L Theigh 30
Knee 20.5
CAlf L 21
Calf R 22.5
Ankle L 11.5
Ankle R 12.5
Wrist 7.25

21 days away. I have been working on losing all of the required weight. I bought some protein powder from unjury. I am very surprised, it tastes good. It can be mixed with water or milk. So far I have tried the chocolate and strawberry. I bought samples of all of them to try.

I got my letter. It is true. I finally got my date 8/25 and the time of 10am! I still have to send in my preadmission paperwork, waiting to get notorized. I weighed myself 293lbs. I need to lose 10 lbs by 8/14.

***Both of the following items were taken from other peoples' blogs. ***

 Ten Mistakes of RNY

1st Mistake: Not Taking Vitamins, Supplements, or Minerals

Every WLS patient has specific nutritional needs depending on the type of surgery you have had. Not only is it a good idea to ask your surgeon for guidelines, but also consult with an experienced WLS nutritionist. Understand there is not a standard practice that all surgeons and nutritionists follow in guiding WLS patients. So, it is important to do your own research, get your lab tests done regularly, and learn how to read the results. Some conditions and symptoms that can occur when you are deficient in vitamins, supplements, or minerals include:

Osteoporosis; pernicious anemia; muscle spasms; high blood pressure; burning tongue; fatigue; loss of appetite; weakness; constipation and diarrhea; numbness and tingling in the hands and feet; being tired, lethargic, or dizzy; forgetfulness, and lowered immune functioning.

Keep in mind, too, that some conditions caused by not taking your vitamins, supplements, or minerals are irreversible.

2nd Mistake: Assuming You Have Been Cured of Your Obesity

A “pink cloud” or honeymoon experience is common following WLS. When you are feeling better than you have in years, and the weight is coming off easily, it’s hard to imagine you will ever struggle again. But unfortunately, it is very common for WLS patients to not lose to their goal weight or to regain some of their weight back.

A small weight regain may be normal, but huge gains usually can be avoided with support, education, effort, and careful attention to living a healthy WLS lifestyle. For most WLSers, if you don’t change what you’ve always done, you’re going to keep getting what you’ve always gotten — even after weight loss surgery.

 3rd Mistake: Drinking with Meals

Yes, it’s hard for some people to avoid drinking with meals, but the tool of not drinking with meals is a critical key to long-term success. If you drink while you eat, your food washes out of your stomach much more quickly, you can eat more, you get hungry sooner, and you are at more risk for snacking. Being too hungry is much more likely to lead to poor food choices and/or overeating.

 4th Mistake: Not Eating Right

Of course everyone should eat right, but in this society eating right is a challenge. You have to make it as easy on yourself as possible. Eat all your meals–don’t skip. Don’t keep unhealthy food in sight where it will call to you all the time. Try to feed yourself at regular intervals so that you aren’t as tempted to make a poor choice. And consider having a couple of absolutes: for example, avoid fried foods completely, avoid sugary foods, always use low-fat options, or only eat in a restaurant once a week. Choose your “absolutes” based on your trigger foods and your self knowledge about what foods and/or situations are problematic for you.

5th Mistake: Not Drinking Enough Water

Most WLS patients are at risk for dehydration. Drinking a minimum of 64 oz. of water per day will help you avoid this risk. Adequate water intake will also help you flush out your system as you lose weight and avoid kidney stones. Drinking enough water helps with your weight loss, too.

6th Mistake: Grazing

Many people who have had WLS regret that they ever started grazing, which is nibbling small amounts here and there over the course of the day. It’s one thing to eat the three to five small meals you and your doctor agree you need. It’s something else altogether when you start to graze, eating any number of unplanned snacks. Grazing can easily make your weight creep up. Eating enough at meal time, and eating planned snacks when necessary, will help you resist grazing. Make a plan for what you will do when you crave food, but are not truly hungry. For example, take up a hobby to keep your hands busy or call on someone in your support group for encouragement.

 7th Mistake: Not Exercising Regularly

Exercise is one of the best weapons a WLS patient has to fight weight regain. Not only does exercise boost your spirits, it is a great way to keep your metabolism running strong. When you exercise, you build muscle. The more muscle you have, the more calories your body will burn, even at rest!

8th Mistake: Eating the Wrong Carbs (or Eating Too Much)

Let’s face it, refined carbohydrates are addictive. If you eat refined carbohydrates they will make you crave more refined carbohydrates. There are plenty of complex carbohydrates to choose from, which have beneficial vitamins. For example, if you can handle pastas, try whole grain Kamut pasta–in moderation, of course. (Kamut pasta doesn’t have the flavor some people find unpleasant in the whole wheat pastas.) Try using your complex carbohydrates as “condiments,” rather than as the center point of your meal. Try sprinkling a tablespoon of brown rice on your stir-fried meat and veggies.

9th Mistake: Going Back to Drinking Soda

Drinking soda is controversial in WLS circles. Some people claim soda stretches your stomach or pouch. What we know it does is keep you from getting the hydration your body requires after WLS–because when you’re drinking soda, you’re not drinking water! In addition, diet soda has been connected to weight gain in the general population. The best thing you can do is find other, healthier drinks to fall in love with. They are out there.

10th Mistake: Drinking Alcohol

 If you drank alcohol before surgery, you are likely to want to resume drinking alcohol following surgery. Most surgeons recommend waiting one year after surgery. And it is in your best interest to understand the consequences of drinking alcohol before you do it.

Alcohol is connected with weight regain, because alcohol has 7 calories per gram, while protein and vegetables have 4 calories per gram. Also, some people develop an addiction to alcohol after WLS, so be very cautious. Depending on your type of WLS, you may get drunker, quicker after surgery, which can cause health problems and put you in dangerous situations.

If you think you have a drinking problem, get help right away. Putting off stopping drinking doesn’t make it any easier, and could make you a lot sicker.

“Dummies” version rewritten by Sally Perez
Original article written by:
Mason. EE, Personal Communication, 1980. Barber. W, Diet al, Brain Stem
Response To Phasic Gastric Distention.
Am J. Physical 1983: 245(2): G242-8 Flanagan, L. Measurement of Functional 

 ***Taken from a friend's blog! I am going to try it, love it, and blog more about it later. Thanks!

If you are pre-op and are looking for something GREAT to do that will be SO HELPFUL to you post-op--here's your ticket--

Put 4 QUARTS of water to a boil in a 10-12 QUART STOCK POT
Take all the skin and all the fat you can off of 3 whole chickens cut into quarters
Put them in the pot.
Add more water to just barely cover the chickens.
Put 2 large whole onions and
3-4 pcs of celery (whole large pcs),
1 large carrot,
1 large parsnip, 
When all the water boils, put the flame on low and let it cook for THREE HOURS. 
You'll see some foamy stuff and fat come to the top, just skim it off.
The longer you cook it, the better the broth will be--it will have more protein the longer you cook it.

After three hours get another large pot or bowl and remove the chickens, the vegetables, and every piece you see.

Then take a HUGE bowl and a VERY FINE strainer. Strain it into the bowl. It will be a clear liquid!!!

Pour it into 4-6 oz portions.

IT IS AMAZING. TRUST ME--I KNOW CHICKEN SOUP!!! 

I cleared this with my surgeon--it is FINE--even if there's a little fat, it's fine--after the portions are refrigerated you can remove the little bit of fat off of it before reheating it.


Taken from another blogger:

I am taking a high dose of A (25,000) because vitamins A, D, and iron are the most common vitamins to become deficent in. 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
So....here is what my day looks like:
2 calcium  with 1 D in the morning
                hour goes by.........
1 multi vitamin, 1 A, 1 zinc
               lunch time.......
1 multi vitamin, 1 zinc
               bed time.......
2 calcium 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
So you are newly post op, what should you take?
Calcium citrate 750mg (one pill twice a day)
D  (either 1000mg or 5000mg) (take with Calcium, one pill twice a day)
A (25,000)
Multivitamin (I like the Equate - Walmart brand for Centrum)
Iron (depending on what your 3 month labs look like)
Zinc (for hair)

Taking the D helps absorption of Calcium.   Any increase in D will depend on blood work. My dose is 50,000 so i only need to take it once a day.  If you are taking the 1000 or 5000mg dose i would take one pill twice a day (take it with the calcium).  

Two rules when taking vitamins:

-You must take your Calcium Citrate (we do NOT want Carbonate or Caltrate b/c they are not as easily absorbed) an hour apart from all other vitamins (only vitamin you can take with Calcium is vitamin D).  

-You must take your iron (only thing you can take with iron is vitamin C) an hour apart from everything else.  

Now that we got those two rules out of the way...let me tell you what i take. First I will list out what i take and then ill talk about them. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Calcium Citrate by Equate (Walmart brand) 

2. Vitamin D
Biotech Dry Vitamin D3-50 (50,000IU) (Cholecalciferol) 100 caps/btl   $24.99 at vitalady.com

3. Vitamin A
Bio-Tech Dry Vitamin A (25,000IU) (Palmitate) 100 caps/btl  $7.49 at vitalady.com

4. Multi vitamin Equate (Walmart brand for Centrum)

5. Zinc by Spring Valley 50mg (for skin)