On the eve of more changes!

Time for an update!  

It's been 9½ months since my gastric bypass surgery.  It has been a bumpy ride right from the start. During my RNY GB surgery they found an 11-pound benign ovarian tumor in my abdomen that really messed with me mentally.  I realize now that I allowed the tumor to be a distraction, and that lesson is very valuable to me even though I'm not certain today how I could have avoided worrying about it as much as I did.  I also had to have a small hernia repair that my bariatric surgeon said she would repair (and didn't) during my  surgery.  Having 3 surgeries in 7 months was definitely a challenge, but trying to start an exercise regimen has also been very difficult.

Mollie Linden, 2010

As of today, I've lost 87 pounds and gained 6 (a net loss of 81 pounds as of today)!  I'm no longer diabetic (my HgA1C is 4.7),  or hypertensive (my BP is normally 110/60 - 106/56), and my cholesterol levels are all exactly where they should be.  I'd really like to reach the "minus 100 pound mark" by my gastric bypass anniversary on 8/11/10.  And, as my recently departed and much loved grand-mother Mollie would say, "God willing..." I'll be successful.  Granny was wise and loving, and once told me that it didn't matter to her if I was fat or thin.  She only wished, sincerely wished,  for me to be happy.  Considering how ill I was when my journey started, I feel lucky and (finally) very happy to be where I am.  I do have to work daily to avoid falling into the trap of wishing I'd lost more weight at this point, and it can be challenging when I look at people who have lost more than me who started when I did.  But my mantra of late, is "stick to modest and attainable goals".

One thing that's halped me immensly, is a change in doctors.  I've moved my care to a really great bariatric clinic that specializes in weight loss and weight loss surgery.   My new doctor is credited with bringing gastric bypass surgery to the Pacific Northwest, and has a long and impressive list of accomplishments, training and education.  As important to me though, is having a kind, open and patient doctor to work with.  Dr. P. is not only accomplished, but caring and warm.  This is only my opinion, but as far as I'm concerned it wasn't too difficult to find a bariatric surgeon who is "good".  It was a little trickier though, to find one who is good and also caring, kind, patient and professional.

Dr. P.'s kindness and warmth were especially evident when I expressed my concerns about my 3-month long "plateau" and weight gain of 6 pounds.  I emotionally explained that my weight was stuck in between 6-pounds, and nothing I was doing seemed to make the difference.  Evidently this is common, easily explained, and not abnormal.  She said I was likely suffering from a still-slow metabolism, and that medications can help initially in speeding up the metabolism!  Before my surgery my metabolism was only operating at 64% of predicted for my height, weight and age.  She's sent me to have a bone density scan done and a metabolic study done.  And now I find myself on the eve of my first meeting with one of Dr. P.'s partners, a bariatric endocrinologist and specialist in metabolic matters for post-op weight loss patients.  Hopefully, Dr. R. will help me figure out the next step to take to move from stuck to GO!  My fingers are crossed!

More to come...
  

All about Gas

Not to be indelicate, but... there really isn't an easy way to launch into this topic daintily.

Gas (not the kind you put in your car, but the kind that originates in the intestines) is one of those topics discussed in the books, blogs, and support groups concerning gastric bypass.  By the time we've had our surgery, most of us have been warned that things would will change for us post-op .  At its best, gas is embarrassing for most of us to discuss even though we realize that it's a natural process.  At its worst - in the months after surgery, some people experience gas as an extremely unpleasant, sometimes worrisome and occasionally incapacitating obstacle to manage.  I've even heard of people who feel they can't leave their homes for fear of, well you know...

Every book written about gastric bypass and post-op expectations covers the topic of flatulence.  When I began experiencing gas in a "new" way for me, I was mortified!  Initially, I complained to my devoted and long-suffering husband until I realized that he was indeed suffering.   For the comfort of my household, for my own edification, and for my readers who might also be experiencing this problem, I decided to research my options.  

So - if you, too, need to learn more about gas and what to do about it, read on.  I'll post here some excerpts from some of the best WLS-oriented blogs, along with links to some of the best documented solutions.  So grab your can of Febreze™, and read on...

Where does gas come from?

Where does gas come from? This post was written on the Thinner Times Forum by user "Pekkale", with several small edits by me, and answers this question better than most.       

The average person expels gas 14 times every day. The amount of actual gas released ranges from as little as one cup to as much as one half gallon per day. Gas is made primarily of odorless vapors such as carbon dioxide, oxygen, nitrogen, hydrogen, and sometimes methane. The unpleasant odor of flatulence comes from bacteria in the large intestine that release small amounts of gases that contain hydrogen sulfide (sulfur smell).   Contrary to popular belief, women have just as many passages as men, and older people, have no more gas than younger individuals.

Flatulence occurs when a food does not break down completely in the stomach and small intestine. As a result, the food makes it into the large intestine in an undigested state. Lower intestinal gas is produced when bacteria in your colon ferment carbohydrates that aren't digested in your small intestine. The body does not digest and absorb certain carbohydrates in the small intestine because of a shortage or absence of certain enzymes.

This undigested food then passes from the small intestine into the large intestine, where normal, harmless bacteria break down the food, producing gases such as hydrogen, carbon dioxide, and in about one-third of all people, methane. As much as 80 to 90 percent of rectal gas (flatulence) is formed by bacteria. Eventually these gases exit through the rectum.     

Certain foods produce more flatulence than others because they contain more indigestible carbohydrates than others. Beans are well known gas producers. The beans pass through the small intestine and arrive in the large intestine without being digested, which causes flatulence to occur.

Unfortunately, healthy foods such as fruits, vegetables, oatmeal and legumes (beans and peas) are often the worst offenders. That's because these foods are high in soluble fiber.  Soluble fiber dissolves in water forming a gelatinous substance in the bowel. Fiber has many health benefits, including keeping your digestive tract in good working order, regulating blood sugar and cholesterol levels, and helping prevent heart attacks and other heart problems. But it can also lead to the formation of gas. In the colon the bacteria thrive on indigestible fiber. 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.  On the other hand, the insoluble fiber found in wheat, rye, bran, and other grains does not dissolve in water, and is not used by intestinal colon bacteria as a food source, so these bacteria generally do not produce intestinal gas. Both soluble and insoluble fiber should be eaten on daily basis.

Sugars are known to create gas. Fructose is naturally present in onions, artichokes, pears, and wheat. It is also used as a sweetener in some soft drinks and fruit drinks. Sorbitol is a sugar found naturally in fruits, including apples, pears, peaches, and prunes. It is also used as an artificial sweetener in many dietetic foods and sugar-free candies and gums.

FOODS THAT CAUSE GAS*
Beans	Vegetables	Fruits	Beverages	Wholegrains	Packaged Foods
Dried Baked  Canned Refried Soy beans Lima beans Seeds Nuts Peas	Cabbage, radishes,  onions, broccoli, brussel sprouts, cauliflower, cucumber, sauerkraut, kohlrabi, asparagus, potatoes, peppers, corn, lettuces,	Prunes; apricots; apples; raisins; bananas	Soft drinks, fruit drinks Milk* *Milk products: Cheese, Ice cream, cottage cheese, yogurt	Whole wheat,  Oat bran,	Look out for foods w/ lactose: Like bread cereals &, salad dressing   Foods w/ Sorbitol: Like dietetic or sugar-free candy/gum

*Table by Lynn Falkow-Short

From an excellent and dynamic website, www.LiveStrong.com, I found this outstanding article:

5 Things You Need to Know About Excess Gas From Gastric Bypass

1. Clear a Crowded Room                                                           
Many people with gastric bypass surgery claim that the gas not only builds up, but that it slips out of the body without control. This type of reaction may be embarrassing but it is a lot better than pain that distention can cause from built up gas. Gastric bypass surgery does two things. It makes the stomach smaller, frequently the size of a walnut, and it removes a portion of the intestines so that the food goes through undigested.

2. Really Rotten                                                                               

If the quality of air around you would not pass the clean air test, it may be for several reasons. The first is the missing intestines. Gastric bypass surgery may push food through the intestines without digesting it. This is because the surgery removed a portion of intestine. This is a part of the digestive system also. The food then moves on not digested and begins to decompose in the lower intestine. Decomposition causes gas to form. Gas forms and has to go somewhere.

3. Check the Food                                                                         

You may not experience problems with gas all the time. Many people find that certain foods bring on gas attacks. Omit normally gaseous foods from the diet, like carbonated soda and milk products. The stomach is not working in full force and many of the digestive enzymes necessary may not be present. Try taking additional food enzymes and acidophilus for the gas.

4. Pop a Beano (or Gas-X Prevention) Before a Meal                                                    

Gas tablets and Beano® after a gastric bypass may become your favorite mealtime addition. If you find that enzymes and acidophilus work, go directly to the Beano or gas tablets to reduce the amount of gas you produce. Gas tablets are good after the fact for unexpected attacks. Beano used on a regular basis can reduce the gas created by the food.

5. Take a Walk and Eat Some Fiber

Exercise is one of the best ways to reduce the amount of gas after a gastric bypass surgery. The increased exercise pushes the additional gas through the system and out. Walking in the great out of doors is a super place to allow the body build-up to escape. Also, try a little extra fiber in the diet to keep the intestinal area clean and free of rotting material that can create gaseous expulsion.

Read more: http://www.livestrong.com/article/9550-need-excess-gas-from-gastric/#ixzz1CnaQInfX

Copyright © 2011 Demand Media, Inc. Use of this web site constitutes acceptance of the LIVESTRONG.COM Terms of Use and Privacy Policy. The material appearing on LIVESTRONG.COM is for educational use only. It should not be used as a substitute for professional medical advice, diagnosis or treatment. 


More information about Gas:  

Products to Consider

It makes sense to consider the following products carefully, and proceed only with your doctors advice about taking any of the specific products listed below.  

Beano® is a food enzyme dietary supplement manufactured by GlaxoSmithKline, that contains Alpha-galactosidase.  Personally, I have found it to be exceptional in managing my particular gas-related issues.  Beano Website  (www.beanogas.com)

Gas-X Prevention™ is a product with the same active ingredient in Beano, and is made by the makers of Gas-x (Novartis).  Each capsule contains twice as much enzyme as found in a capsule of Beano (but remember, everyone is different, and therefore more enzyme may not be better). Gas-x Prevention Website (www.gas-x.com)

Simethicone is a generic medication found in numerous over the counter preparations including:  Phazyme; Flatulex; Mylicon; 

Gas-X (not to be confused with Gas-X Prevention); Mylanta Gas, 

and many more.

       Phazyme

       Mylanta Gas

       Flatulex Information Hub