3 Weeks and 3 Days Post Op-RNY- A few comments amd concerns.

First off please accept my sincere appreciation for your heartfelt advice and encouragement thus far. It has been invaluable and and my thanks are sincere. I will start with a short De-brief of my experience so far. My RNY was performed on Dec 3, 2014. My initial Surgeon visit was May 23, 2014 and at that time I was informed that my Ins.-BC/BS of South Carolina required 6 month of weight loss consultation with my surgeon, esophageal and Gall Bladder analysis, Full Blood work up (tests), a visit with a nutritionist, and my PCP recommendation. What was unusual in my ins. requirements was that no psychological exam was needed. I lost no weight the first 3 months after seeing my surgeon, however after meeting with my Nut in Sept I lost 42lbs in the 3 months(from 294 to  252 prior to my surgery. My Concern # 1 is that I have only lost 14 lbs. in the 24 days since my surgery (down to 238). my diet has been eating vast majority protein a few protein shakes , but mostly food, lo fat cheese, fish chicken, some beans and nuts. also a bit unusual was that my surgeon started me on solid food 10 days post op (clear liquids until that point) and I am wondering if this may have stymied my early loss. His reasoning was that since beginning doing RNY in the mid 90's he found that the incidents of stomach strictures much higher for those on pureed and lower incidence for those he placed on solid foods with instruction to chew to puree consistency. I have had no problem eating this way but as I said I wonder if this is slowing my weight loss, or whether it was the pre surgery high weight loss or a combination of both. One last matter is that I returned to work fairly early to a pretty physically demanding job at 19 days post op, and my energy levels are really struggling. I simple can not afford to take off any more time. Any suggestions to help increase my energy as I am on my feet and moving briskly for nearly the entire 9-10 hours I am at work would be much appreciated. Of positive note I had been feeling a lot of discomfort recently from prior unrelated surgery that I had been using NSAIDS to control prior to my RNY. Since surgery I obviously have not taken the NSAIDS nor had I taken Tylenol as Acetaminophen never helped with the pain previously. Today however I did take 2 extra strength Tylenol and they  unexpectedly gave me a good amount of relief, so please don't avoid trying it for a little relief-as I had-you never know.

I am also a newbie so not mch in the way of advice. However, when I did go back to work I increased my protein shakes from 2 to 3 a day. I drink 2 during the work day and that has helped with my energy levels to get through the work day. 

The program I followed had a liberal post-op diet---I was eating 1/4 cup of chili at two weeks out with no problems nor concerns that it would slow the effortless weight loss.  The psychological exam didn't amount to much so I wouldn't give that two seconds thought.  The only thing I have to say about your work schedule is I could not have been able to do what you are doing but am hoping you are drinking plenty of water.  When I took 2 extra strength Tylenol, it would put me right to sleep--how do you stay awake?

You've lost almost 60 lbs in 4 mos!  That's great!!  Also, remember those darned stalls creep in about 3 weeks post op. I was stalled for a while. It's depressing but when it breaks, you'll drop several lbs. I, too, have a pretty physically demanding job. I've not had my post op blood work done yet, that's in a couple of weeks. When I feel my energy lagging, I will have a cup of coffee which seems to help a lot. I'm sure when they adjust my vitamins after blood work, the energy thing will resolve. But I still do enjoy my afternoon coffee!

As it relates to your energy and working our you take B12? The once a week nasal spray helped my energy tremendously. I am no expert but based on what I have read on this board, I think your weight loss is awesome thus far! 

Energy:. Hydrate hydrate hydrate...

If you have lunch break - try taking 30 min nap. (Even in your car). That helped me more that anything else during first few weeks.

When you work 9-10 hours - most state labor laws require to have lunch break.  You may need to talk to HR to see how they can accomodate you in the next 2-3 months. 

I definitely agree that Hydrating may be where I am lacking,. The difficulty is that health standards requires leaving food preparation areas each time a drink is taken (followed by proper cup disposal and hand washing), so sipping often is very difficult, but I have and will continue to make achieving this my priority. HR does not have a problem with me taking a break at all...I  personally found it very difficult as a chef/manager to take the time away from the department.= I returned last week on Christmas week-our busiest of the year but now that it is done I will make myself take a break daily. Thanks.

I used to wear a "camel back" in my days on the hot line.  You might be able to wear it as it is in a closed system and not open liquids.

You básica ley losa THE "Easy" lbs befo re surgery. Since, you are loosing almost 5lbs per week and that is a good steady loss.  It is basically the same I am loosing now after the crazy first month. (This you did before surgery)

as for energy I've been doing two things.  Taking B12+b complex shots.  Also, I drink two Petite natural juice boxes through the day.  This last brings in some sugars that are used rapidly in your system.

best of luck

Thank you  Sum, I did get the B-12 shot 2 weeks ago and I am taking the B complex daily (I did not know that the complex was available in injection form-I will check into that. Re: The Petite Juice Boxes, My surgeon said fruit juice is not recommended for me. I am glad that they are helpful for you though.