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Post-bariatric riders?

Old 04-05-12, 02:32 PM
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Post-bariatric riders?

I just read with interest the posting by Durockrolly, "Question for my fellow diabetics." He attracted some very good input. I was diabetic for more than 15 years and had all the side-issues that went with it until I underwent gastric bypass surgery in 2009. Within a year after my surgery, my diabetes (and the 93 units of insulin daily) disappeared.

However, since then I have performed a daily balancing act of exercise, nutrition, fitness, weight loss, hypoglycemia, pulse rates, blood pressure and several other issues, including the bothersome after-effects of my diabetes (sore feet, swollen ankles, infections).

I would appreciate hearing from any other bike riders who had bariatric surgery to learn how they're coping with a whole different set of health and fitness problems that, in their entirety, seem to be unique to former diabetics who are trying to live more normal lives.
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Old 04-05-12, 05:00 PM
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Check the Clydesdale forum... but do come back and update us.
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Old 04-06-12, 04:55 AM
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Welcome! I had RNY GBP in 2003. Unbelievable that I'm coming up on nine years now.

I was up to 475 pounds at one point. Had surgery when I was about 425. I got down to 162 at my lowest, but am now floating in the 170-180 range. For the first few years everything was golden. I didn't want to eat, and I couldn't eat much even if I wanted to. It's a different story now. I feel pretty much no restriction on the amount of food I can eat. I can only take in so much sugar without getting "dumping syndrome" so that's at least some limitation But I will have to fight whatever it is in me that makes me overeat for the rest of my life. For awhile the surgery did the work, but now it's all on me.

I walked and ran for exercise at first, but my right knee is pretty munged up from when I was so overweight. For awhile I had to walk with a cane. I switched to riding when I got down to 250 or so, because it looked like fun, and I had ridden a ton when I was in highschool. It all came back how much fun it was. Only the technology had changed. It was a true "Rip Van Winkel" effect when I went into a bike shop for the first time in 30 years

The surgery doesn't have any real effect on my riding now, since as I said I can take in unrestricted amounts of liquids and foods. I try to avoid heavy hits of sugary stuff while riding. I save the GU's for the end of the ride when I just can't take in solid food any more.

I went from not being able to walk up my own driveway in 2003 to riding 9600 miles last year, and am way ahead of that pace for this year. I can honestly say that if it weren't for bike riding I would probably have regained at least 50 or 75 pounds, and maybe more.

So I'll keep riding!
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Old 04-06-12, 10:54 AM
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Jim: Wow! Congratulations on the results of your RNY and for your decision to make it happen. No one who hasn't gone through it can know how hard it is to make such a life-changing decision, and the irony is, years of dedication and hard work are required for years afterward.


We went through some of the same adjustments with our early post-surgery eating, and I have the same problem you do with sugar.


I don't have ANY problem overeating, however, because if I eat too much or too fast, I throw up. I find myself struggling to consume enough nutritious, high-protein food. According to my doc, when I'm riding my bike, I need about 1,800 calories a day in order to maintain my current weight. I almost never get that much, so my weight can drop 5-7 pounds within a few days if I'm not careful.


I do have to frequently remind myself not to eat what my wife calls "empty calories" that fill me up but don't provide the nutrients I need. I can eat ice cream, for example, but I don't very often do it for that reason.


I know what you mean about the Rip Van Winkel effect; I was amazed when I learned about the cost and gearing and equipment of new bikes.


I hear about people like you who can "take in unrestricted amounts of liquids and foods," but I'm not one of them. Part of what controls my eating is an ulcer that my doc says I'll have for the rest of my life; it resulted from my SECOND RNY surgery.


Like you, I'm convinced that if it weren't for bike riding, I'd weigh more than I do. I was able to maintain my weight last winter by walking every day, but it's no fun, and I don't think I could do it all year.


You're riding a whole lot more than I am, and you deserve to be proud of your 9,600 miles. I consider myself a beginner since this is my second year for it. Last year I rode about 2,500 miles. My goals are to go the 20 miles daily that I did last fall and then prepare for a 30-mile charity ride in June.


I'd really be interested to learn how you got to your point. Did you build up your distances, times and speeds gradually? Where do you ride? How old are you? What and when do you eat to prepare for a long ride? How do you handle recoveries?


After I posted the entry to which you responded, DiabloScott recommended I check out the Clydesdale forum, so I did, and I posted a new thread there with the same title as this one, hoping to generate some discussion.


Here is what I posted there:


I posted this question on the 50-plus section of the forum and was advised to come here. Didn't know about this section and thought it was about something involving horses. lol


I joined the forum a couple of weeks ago, asked some questions about nutrition, after-ride recovery ideas and a few other related areas, only to learn that none of the answers would work for me.


Sometimes I'm a little slow on the uptake (senior moments, don't you know), but it's now quite clear that riders who went through gastric bypass surgery often have several health issues that other riders don't -- especially if pre-surgery life included serious Type II diabetes, high blood pressure, high cholesterol, neuropathy and other related foibles.


So I'm asking if there are other riders here who had bariatric surgery and, like me, are learning how to cope with balancing exercise, nutrition, fitness, weight loss, hypoglycemia, pulse rates, blood pressure and the various other left-over side-effects.


In case there's a discussion to be generated here, I'll start it off.


I'm 73 and had RNY surgery in early 2009, at which point I weighed 284 pounds (at just under 5'8"). I was rapidly approaching an appointment with the grim reaper and knew it. My diabetes was getting worse, and I was injecting 93 units of insulin daily. In addition to high blood pressure/cholesterol/neuropathy, I used a ventilator at night for sleep apnea and had a troublesome, enlarged prostate. I was spending $800 a month on medication.


I couldn't bear the thought of leaving my lovely wife alone (who was she going to boss around if I were gone?), and I wanted to watch my six grandchildren grow up.


After trying various diets for 30 years, I realized gastric bypass was my last and best option, and I went into it fully knowing there could be complications and that I'd spend the rest of my life coping with a new digestive system.


Unfortunately, the surgery was botched, and in the middle of the night 10 days later, I found myself in an ambulance headed to the hospital emergency room. A hole about the size of a dime was found in my new egg-size pouch, and my interior was flooded with bile and nastiness that had to be vacuumed out.


A constant stream of nurses flowed into and out of my room after the surgery, and I couldn't figure out why until one of them told me they were there to see the results of the heroic operation that a handsome young doctor had performed. I was, she said, literally minutes away from death.


Now, those of you who have gone through gastric bypasses know that you're almost nagged to death to get out of bed and walk, walk, walk following surgery. There was none of that after my second surgery. In fact, I needed help to make it to the toilet.


I was weak, had a series of vitamin, mineral and electrolyte deficiencies, my blood pressure was out of control, and I had acquired four rather severe staph infections. Finally, after nearly a week in the hospital bed, my wife took me home because she was certain the hospital was going to kill me.


At home, I forced myself out of bed each day and walked around the block (one-third of a mile) with the help of a cane. A month later, I was walking a mile. Then two miles and finally by the end of the year, four miles. Meanwhile, my weight dropped to under 200 pounds, and I reduced my daily insulin from 93 units to 25.



During the spring of 2010, I climbed aboard my 1980 Huffy six-speed bike and rode around and around as long and as fast as I could until by year's end, I was riding up to 10 miles daily and was sick of my neighborhood. But by that time, I was down to 164 pounds; my blood pressure and cholesterol were normal; my sleep apnea was gone, and so was my diabetes. Neighbors talked to each other about "the crazy old fat guy with the cane" who was now riding a bicycle!


Along the way, however, I learned I had a few unpleasant side-effects from my surgeries. First, it took nearly five months to get rid of the staph infections. Then the scar tissue from my second surgery evolved into a permanent stomach ulcer which then resulted in a series of four different esophageal strictures that had to be treated by balloon inflations down my throat. Much of my new weight loss was due to the liquid diets I was on before and after each inflation.



In addition, a long-term potassium deficiency worsened. Swollen legs and an inclination to infections were left-over side-effects from the diabetes. Each minor cut or scrape must be treated carefully with first-aid and usually antibiotics.


I regained 20 pounds that winter and was determined to lose it by bike riding. As soon as the weather permitted, I hauled my Huffy to the nearby bike trails and began an earnest fly-by-the-seat-of-my-pants training program. I also had a LBS re-gear the bike for 12 speeds. It worked. By fall, my weight was 170 pounds and I was riding 20 miles nearly every day. During the winter, I kept fit and maintained my weight by brisk walking inside a shopping mall up to 3.6 miles daily.


In March 2012, I gave myself a new 21-speed Giant Cypress for my 73rd birthday and set out to regain the 20-mile distances I had ridden the previous fall. After gradually increasing my time and distances, I'm now riding 14-18 miles and averaging 12 mph.


However, each day I face a struggle with health-related issues.


Like many other post-bariatrics people, I have to eat six or eight small meals every day. I can't ingest acidic foods such as oranges because of the ulcer. No chocolate or caffeine or carbonated beverages for the same reason. Can't digest anything that won't chew up to a mushy consistence. That means no dense meat such as steak or pork chops. No spicy food; no garlic. No stringy veggies such as broccoli, no fruit with skins such as grapes. Greasy foods are often a problem. I can't handle sodium-rich food or drinks such as Gatorade due to the neuropathy.


Unlike non-bariatric riders, I have to eat a nutritious breakfast before beginning my early morning ride because I have no energy reserves left from my evening meals. But since my egg-size stomach won't handle much food, I can't eat much more than some oatmeal with milk, a very small protein shake and a slice of rye toast slathered with peanut butter. And halfway through my ride, I have to stop and eat either a power bar or a couple of peanut butter crackers. If I don't do that, by the time I'm finished riding, I have seriously low blood sugar -- hypoglycemia -- that puts me out of action for the rest of the day with shaking hands, weak arms and legs, slurred speech, blurred vision and almost uncontrollable sleepiness.


At the end of my ride, I am always famished and generally refuel with a soft-poached egg mixed with a small, chopped up microwaved potato and some sour cream. Lately, I've also been adding half a high-protein shake.


Warning: Do NOT pay attention to bike riders who tell you that you cannot digest and absorb food effectively if you eat it within two hours before your ride. That advice might apply to non-bariatric people, but not to riders whose digestive systems have been altered the ways ours have.


Similarly, IGNORE the advice of those who say if there has been adequate nutrition the day before a ride, the muscles with have a full complement of glycogen in the morning and that an overnight fast does not deplete your body's supply of energy. That just doesn't work for us.


Enough about me. If there's anyone out there like me, let's hear it.

Don
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Old 04-07-12, 01:08 AM
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Originally Posted by RVwriter
I'd really be interested to learn how you got to your point. Did you build up your distances, times and speeds gradually? Where do you ride? How old are you? What and when do you eat to prepare for a long ride? How do you handle recoveries?
Yeah, I just kept riding more and farther. The first year I was on a hybrid, and did about 20 miles a ride maybe 2 or 3 times a week. The next year I got a nice road bike, and rode it as much as 40 or 50 miles on weekend rides, plus some after-work rides. I was still running a lot at that point too, so the running helped my cardio.

Problem was that I had so much excess skin on my abdomen and on my upper thighs that I had a lot of issues with rashes, and appearance frankly. I physically couldn't use bike shorts even in the summer because the skin on my upper thighs would flap against the top tube. So I had to use tights even in the summer. I had a series of surgeries to remove the excess skin over 2004-2005, and after that I concentrated on riding rather than running.

I did my first century (solo) in 2006 I think. I did three total that year including two organized century rides. That really got me hooked. We have great beautiful and historic locations to ride here in Virginia, so I enjoy the challenge of long all-day rides. I'm not fast, but I get there eventually.

I just turned 55. I usually carry a couple of Cliff Bars or Powerbars with me, and some GU packs as well as endurolyte tablets for the summer and a sleeve of Clif shotBloks. I prefer to stop at little country stores, or gas stations or whatever, to get fresh fruit, or maybe some chips, and some Diet Coke, and save the bars for if I stop at a park or something.
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